CPT code 42106: Palate excision, simple primary closure2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $255.54 for 42106 in the office and $143.98 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 42106 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 42106 covers

This service removes a lesion from the palate or uvula and closes the resulting wound with a simple primary closure. It is typically performed by an otolaryngologist or oral and maxillofacial surgeon in an office or facility setting. The lesion may be submitted for pathologic examination; the code choice follows the operative method of removal and closure, not the eventual pathology result.

Report this code when the surgeon excises the lesion and closes the site directly without a local flap. The operative note should identify the palate or uvula site, describe the excision and closure, and distinguish simple closure from closure using a flap. CMS assigns a 10-day global period, including related postoperative visits during that interval. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service; 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.

How South Dakota compares for 42106

Across 109 of 109 payment localities, the office rate for 42106 runs from $231.44 in Arkansas to $345.67 in San Benito County, CA. South Dakota pays $255.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42106 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 42106 in every payment locality

How the 42106 rate is calculated

Each of 42106’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.

Payment rules and modifiers for 42106

42106 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 42106

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 42106 has changed in South Dakota

Price 42106 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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

Open CMS sourceHow we calculate rates