CPT code 42182: Palate repair, laceration 2 cm or greater2026 Medicare rate & RVUs

Medicare pays $329.00 for 42182 nationally in the office and $227.79 in a hospital or facility. Local office rates run $294.16–$416.27.

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

What 42182 covers

CPT 42182 describes surgical closure of a palate laceration that measures at least 2 cm. The injury may involve the hard or soft palate. Otolaryngologists, oral and maxillofacial surgeons, and other surgeons who manage oral trauma may perform the repair in a hospital or other surgical setting. This is for closing a traumatic wound, not for removing a palatal lesion or performing planned reconstruction.

Report the code when the documented wound length meets the 2 cm threshold; record the injury site, measured length, and repair performed. The code has a 10-day global period, so related postoperative visits during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery is paid only when medical necessity is documented; 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 42182 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

42182 rates by state

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

How the 42182 rate is calculated

Each of 42182’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 42182

42182 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

42182 compared with similar codes

How to choose

42180Palate repairLaceration under 2 cm

Both codes repair palatal lacerations; 42180 is for wounds under 2 cm, while 42182 is for wounds measuring 2 cm or greater.

42145PalatopharyngoplastyPalate and pharynx repair

42145 describes a palatopharyngeal or uvular procedure, rather than closure of an acute palatal laceration.

42120Palate resectionExtensive lesion or palate

42120 is used to remove a palatal lesion; 42182 closes a traumatic laceration.

40831Laceration repairComplicated vestibular wound

40831 applies to a laceration of the oral vestibule. Use 42182 when the repaired wound is on the palate and meets its length threshold.

Codes related to 42182

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

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