$306.22
41250 is for simple tongue-laceration repair. Choose 41251 when the documentation supports a complicated repair.
On this page
CMS RVU26D · Effective 2026-10-01
41251 Tongue repair Medicare reimbursement rates in Iowa
Reports operative repair of a complicated tongue laceration when the documented wound and repair support the complicated level rather than simple closure. Compare 41251 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 41251 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$388.40
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$204.42
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Oral surgery
About 41251: Complicated tongue laceration repair
Reports operative repair of a complicated tongue laceration when the documented wound and repair support the complicated level rather than simple closure.
This service covers repair of a complicated laceration of the tongue. It is commonly performed by an emergency physician, otolaryngologist, or oral and maxillofacial surgeon in an emergency department or hospital setting. The record should identify the tongue wound and describe its extent, depth, tissue disruption, and repair technique sufficiently to support the complicated level; the fact that sutures were placed alone does not establish that level.
Select this code based on the documented complexity of the tongue wound and repair, distinguishing it from the simple repair code and the other tongue-repair family entry. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 41251
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.26 · 18%
- Practice expense (office) RVU10.00 · 78%
- Malpractice RVU0.55 · 4%
21
Medicare services in 2024 · #5894 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
41251 compared with similar codes
Office rates for Iowa, from the same CMS release.
$314.79
41252 is another distinct tongue-laceration repair entry. Select between the family codes using the specific wound and repair circumstances in the applicable descriptor.
$287.30
40831 describes complicated repair at the oral vestibule. A laceration of the tongue is reported with the applicable tongue-repair code instead.
Compare 41251 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$388.40
Facility
$204.42
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 41251 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
4,917
- Code
- 41251
- Physician work
- 2.26
- Practice expense
- 10.00
- Malpractice
- 0.55
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.26 | × 1.000 | 2.2600 |
| Practice expense | 10.00 | × 0.915 | 9.1500 |
| Malpractice | 0.55 | × 0.397 | 0.2184 |
| Total RVUs | 11.6283 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$388.40
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.26 | 1 |
| Practice expense | 10 | 0.915 |
| Malpractice | 0.55 | 0.397 |
(2.26 × 1 + 10 × 0.915 + 0.55 × 0.397) × $33.4009 = $388.40
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.26 | 1 |
| Practice expense | 3.98 | 0.915 |
| Malpractice | 0.55 | 0.397 |
(2.26 × 1 + 3.98 × 0.915 + 0.55 × 0.397) × $33.4009 = $204.42
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
41251 billing questions
How is this code distinguished from 41250?
41250 is the simple tongue-laceration repair code. Use 41251 when the documented wound and repair support the complicated level, not merely because the wound was sutured.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% reduction.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
Should modifier 50 be appended for a tongue wound?
No. Modifier 50 is inappropriate for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,9144120F,,Antibiot rxd/given,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9154124F,,Antibiot not rxd/given,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,91641250,,Repair tongue laceration,A,,1.91,7.75,,2.66,,0.42,10.08,4.99,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,91741251,,Repair tongue laceration,A,,2.26,10.00,,3.98,,0.55,12.81,6.79,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,91841252,,Repair tongue laceration,A,,2.94,6.87,,2.41,,0.50,10.31,5.85,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9194130F,,Topical prep rx aoe,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9204131F,,Syst antimicrobial thx rx,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136