Billing code 41251: Tongue repairMedicare rate & RVUs in Washington
Reports operative repair of a complicated tongue laceration when the documented wound and repair support the complicated level rather than simple closure.
Medicare pays $442.16–$504.10 for 41251 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 41251 covers
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.
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 41251 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $442.16 | $230.43 |
| Seattle (King Cnty) | $504.10 | $257.38 |
How the 41251 rate is calculated
Each of 41251’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 · 41251
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.26Practice expense 10.00Malpractice 0.55
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 41251
41251 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41251
Tongue repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 41251
Tongue repair
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
41251 without 51 · national office
$427.87
Tongue repair
41251-51 · Second procedure: 50%
$213.94
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%).
41251 compared with similar codes
Compare codes
41251 vs 41250 vs 41252 vs 40831: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 41250Tongue repair
- 41250 is for simple tongue-laceration repair. Choose 41251 when the documentation supports a complicated repair.
- 41252Tongue repair
- 41252 is another distinct tongue-laceration repair entry. Select between the family codes using the specific wound and repair circumstances in the applicable descriptor.
- 40831Laceration repair
- 40831 describes complicated repair at the oral vestibule. A laceration of the tongue is reported with the applicable tongue-repair code instead.
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 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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