CPT 41251 Surgery - Digestive

How Much Does Repair tongue laceration Cost?

Repair tongue laceration (CPT 41251) costs $227 at Medicare rates. Hospital outpatient rate: $242.

Cost Comparison by Payer

How much Repair tongue laceration costs across different settings and payers

Medicare
Facility rate
$227
Hospital Outpatient
OPPS rate
$242
Surgery Center
ASC rate
$130
Medicare (Facility)
$227
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$428
Non-facility setting
Hospital Outpatient
$242
OPPS rate
Surgery Center (ASC)
$130
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside Repair tongue laceration

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How to Reduce Your Cost for Repair tongue laceration

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($428) differs from the facility rate ($227). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $130, compared to $242 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.26
Work RVU
3.98
Practice Expense RVU
0.55
Malpractice RVU
12.81
Total RVU

Payment = Total RVU (12.81) x CF ($33.40) = $428

Frequently Asked Questions

How much does Repair tongue laceration cost?

The Medicare facility rate for Repair tongue laceration is $227. In a hospital outpatient setting, the rate is $242. At an ambulatory surgery center, the rate is $130. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Repair tongue laceration cost without insurance?

Without insurance, the cost of Repair tongue laceration can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Repair tongue laceration?

Most commercial health insurance plans and Medicare cover Repair tongue laceration when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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