Billing code 41520: FrenuloplastyMedicare rate & RVUs in Texas
Reconstructs the lingual frenulum to improve restricted tongue movement, commonly when ankyloglossia requires more than simple division or excision.
Medicare pays $337.12–$374.55 for 41520 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 41520 covers
billing code 41520 describes surgical reconstruction of the lingual frenulum, the fold of tissue beneath the tongue. It is commonly used for ankyloglossia when restricted tongue movement calls for frenuloplasty rather than simple division or removal of the frenulum. Otolaryngologists and oral and maxillofacial surgeons may perform the procedure in an office or operating-room setting, depending on the patient and the planned repair.
Select the code when the operative work reconstructs or lengthens the tongue fold; document the functional restriction, relevant anatomy, and repair performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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.
Where 41520 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$337.12 to $374.55
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $374.55 | $236.37 |
| Beaumont | $337.12 | $218.27 |
| Brazoria | $356.56 | $227.14 |
| Dallas | $358.97 | $228.90 |
| Fort Worth | $356.59 | $227.82 |
| Galveston | $357.71 | $228.03 |
| Houston | $365.04 | $235.35 |
| Rest Of Texas | $346.74 | $222.80 |
How the 41520 rate is calculated
Each of 41520’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 41520
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.76Practice expense 7.65Malpractice 0.40
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 41520
41520 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41520
Frenuloplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 41520
Frenuloplasty
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
41520 without 51 · national office
$361.06
Frenuloplasty
41520-51 · Second procedure: 50%
$180.53
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
41520 compared with similar codes
Compare codes
41520 vs 41115 vs 41510 vs 41512 vs 41599: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 41115Tongue-tie surgery
- billing code 41115 describes excision of the lingual frenulum. Report 41520 when the operative service reconstructs or lengthens the tongue fold.
- 41510Tongue adhesion
- This is tongue-to-lip surgery, a distinct operation from lingual frenulum reconstruction. Choose according to the procedure actually performed.
- 41512Tongue suspension
- This code describes tongue suspension, not repair of the lingual frenulum. The operative target and technique determine the choice.
- 41599Unlisted px tongue flr mouth
- Use the unlisted tongue or floor-of-mouth code only when a specific code does not describe the operation; 41520 specifically covers tongue-fold reconstruction.
41520 billing questions
How does 41520 differ from lingual frenulum excision?
Use 41520 for reconstruction or lengthening of the tongue fold. billing code 41115 describes excision of the lingual frenulum; choose based on the operative work documented.
What documentation supports 41520?
Document the restricted tongue movement and relevant frenulum anatomy, along with the reconstructive technique performed. The note should make clear why the service was reconstruction rather than simple division or excision.
Is modifier 50 appropriate for this procedure?
No. The anatomy and descriptor make bilateral adjustment inappropriate.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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