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

Repair a palatal laceration measuring 2 cm or greater, typically after oral or facial trauma requiring surgical closure.

CMS RVU26DEffective Oct 1, 2026One payment locality17 Medicare services in 2024

In Washington, DC area, Medicare pays $370.77 for 42182 in the office and $251.55 when it’s performed in a hospital or facility.

$370.77Office (non-facility)
$251.55Hospital or facility
+12.7%vs the national office rate ($329.00)

Check a contract rate as a % of Medicare · 42182 nationwide

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

We’ll open 42182 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 42182 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Washington, DC area compares for 42182

Across 109 of 109 payment localities, the office rate for 42182 runs from $294.16 in Arkansas to $416.27 in San Benito County, CA. Washington, DC area pays $370.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

42182 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$370.77
  2. Los Angeles, CA · California$361.96−$8.81
  3. Miami, FL · Florida$364.16−$6.61
  4. Chicago, IL · Illinois$354.16−$16.61
  5. Manhattan, NY · New York$377.60+$6.83
  6. Alaska · Alaska$395.89+$25.12
  7. Alabama · Alabama$298.04−$72.73

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

42182 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$294.16$207.23
ArizonaArizona$320.67$222.60
Bakersfield, CACalifornia$342.10$231.18
Chico, CACalifornia$340.53$229.61
El Centro, CACalifornia$340.62$229.70
Fresno, CACalifornia$340.53$229.61
Hanford, CACalifornia$340.53$229.61
Madera, CACalifornia$340.53$229.61

42182 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$294.16

$395.89

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
42182 office rate range by state
State / territoryOffice rate rangeLocalities
AK$395.891
AL$298.041
AR$294.161
AZ$320.671
CA$340.53–$416.2729
CO$338.401
CT$349.551
DC$370.771
DE$325.591
FL$329.93–$364.163
GA$312.48–$335.962
GU$346.761
HI$346.761
IA$302.391
ID$304.691
IL$323.05–$354.164
IN$306.221
KS$302.291
KY$306.931
LA$306.96–$320.532
MA$337.16–$368.082
MD$331.00–$370.773
ME$307.38–$320.682
MI$315.23–$334.902
MN$321.671
MO$302.99–$320.153
MS$298.571
MT$328.961
NC$310.091
ND$318.291
NE$303.531
NH$334.331
NJ$352.81–$367.762
NM$317.271
NV$326.171
NY$314.39–$387.495
OH$313.041
OK$305.181
OR$322.90–$346.942
PA$312.83–$342.332
PR$330.761
RI$335.551
SC$312.231
SD$317.021
TN$303.811
TX$311.06–$337.938
UT$316.061
VA$320.55–$370.772
VI$330.761
VT$318.241
WA$336.13–$374.002
WI$308.751
WV$312.531
WY$324.311

See 42182 in every payment locality

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.

How the rate is built · 42182

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.77

3.77 RVUs× 1.000 GPCI

Practice expense5.54

5.54 RVUs× 1.000 GPCI

Malpractice0.54

0.54 RVUs× 1.000 GPCI

Adjusted RVUs

9.8500

Conversion factor

$33.4009

Medicare rate

$329.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,003

Code
42182
Physician work
3.77
Practice expense
5.54
Malpractice
0.54

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 42182 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work3.77× 1.0543.9736
Practice expense5.54× 1.1786.5261
Malpractice0.54× 1.1130.6010
Total RVUs11.1007
Conversion factor× 33.4009

Office rate, Washington, DC area$370.77

Office: (3.77 × 1.054 + 5.54 × 1.178 + 0.54 × 1.113) × $33.4009 = $370.77

Facility: (3.77 × 1.054 + 2.51 × 1.178 + 0.54 × 1.113) × $33.4009 = $251.55

Open 42182 in the RVU calculator

Payment rules and modifiers for 42182

42182 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 42182

Palate repair, laceration 2 cm or greater

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 42182

Palate repair, laceration 2 cm or greater

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

42182 without 51 · national office

$329.00

Palate repair, laceration 2 cm or greater

42182-51 · Second procedure: 50%

$164.50

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%).

When to use modifier 51

Codes related to 42182

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

Codes related to 42182
CodeHow it relatesOffice range, Washington, DC area
Same family
42180Palate repair, laceration under 2 cmPalatal laceration repair for wounds under 2 cm.$289.12
Used instead
40830Mouth laceration repair, simple vestibular repairRepair code for a laceration of the oral vestibule rather than the palate.$265.23
40831Laceration repair, complicated vestibular woundAlso addresses oral vestibule lacerations; select by site, not as a palatal repair.$357.15

How 42182 has changed in Washington, DC area

42182 · Office / nonfacility

$370.77

Effective 2026-10-01

The base rate is $7.16 higher than on 2025-10-01, moving from $363.61 to $370.77 (2.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $363.61changed to$370.77

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.87 changed to 3.77
    • Practice expense RVU 5.45 changed to 5.54
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $377.36changed to$363.61

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.53 changed to 5.45

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $371.20changed to$377.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $390.16changed to$371.20

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.56 changed to 5.53
    • Malpractice RVU 0.55 changed to 0.56
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $401.06changed to$390.16

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.49 changed to 5.56
    • Malpractice RVU 0.56 changed to 0.55
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $396.13changed to$401.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.33 changed to 5.49
    • Malpractice RVU 0.53 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $388.62changed to$396.13

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.94 changed to 5.33
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $380.93changed to$388.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.84 changed to 4.94
    • Malpractice RVU 0.55 changed to 0.53
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $380.02changed to$380.93

    • Malpractice RVU 0.53 changed to 0.55

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $372.70changed to$380.02

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.66 changed to 4.84
    • Malpractice RVU 0.55 changed to 0.53

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $378.22changed to$372.70

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.80 changed to 4.66
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $382.30changed to$378.22

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.88 changed to 4.80
    • Malpractice RVU 0.57 changed to 0.55
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $381.05changed to$382.30

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.83 changed to 4.88
    • Malpractice RVU 0.56 changed to 0.57

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $379.15changed to$381.05

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $379.00changed to$379.15

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.95 changed to 4.83
    • Malpractice RVU 0.47 changed to 0.56
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $379.10changed to$379.00

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.45 changed to 4.95
    • Malpractice RVU 0.49 changed to 0.47
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $379.10

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$370.77$251.55RVU26D
2026-07-01$370.77$251.55RVU26C
2026-04-01$370.77$251.55RVU26B
2026-01-01$370.77$251.55RVU26A
2025-10-01$363.61$284.18RVU25D
2025-07-01$363.61$284.18RVU25C
2025-04-01$363.61$284.18RVU25B
2025-01-01$363.61$284.18RVU25A
2024-10-01$377.36$291.66RVU24D
2024-07-01$377.36$291.66RVU24C
2024-04-01$377.36$291.66RVU24B
2024-03-09$377.36$291.66RVU24AR
2024-01-01$371.20$286.90RVU24A
2023-10-01$390.16$298.42RVU23D
2023-07-01$390.16$298.42RVU23C
2023-04-01$390.16$298.42RVU23B
2023-01-01$390.16$298.42RVU23A
2022-10-01$401.06$303.54RVU22D
2022-07-01$401.06$303.54RVU22C
2022-04-01$401.06$303.54RVU22B
2022-01-01$401.06$303.54RVU22A
2021-10-01$396.13$299.52RVU21D
2021-07-01$396.13$299.52RVU21C
2021-04-01$396.13$299.52RVU21B
2021-01-01$396.13$299.52RVU21A
2020-10-01$388.62$300.49RVU20D
2020-07-01$388.62$300.49RVU20C
2020-04-01$388.62$300.49RVU20B
2020-01-01$388.62$300.49RVU20A
2019-10-01$380.93$297.98RVU19D
2019-07-01$380.93$297.98RVU19C
2019-04-01$380.02$297.07RVU19B
2019-01-01$380.02$297.07RVU19A
2018-10-01$372.70$295.49RVU18D
2018-07-01$372.70$295.49RVU18C
2018-04-01$372.70$295.49RVU18B
2018-01-01$372.70$295.49RVU18AR1
2017-10-01$378.22$299.52RVU17D
2017-07-01$378.22$299.52RVU17C
2017-04-01$378.22$299.52RVU17B
2017-01-01$378.22$299.52RVU17A
2016-10-01$382.30$302.48RVU16D
2016-07-01$382.30$302.48RVU16C
2016-04-01$382.30$302.48RVU16B
2016-01-01$382.30$302.48RVU16A
2015-10-01$381.05$302.24RVU15D
2015-07-01$381.05$302.24RVU15C
2015-04-01$379.15$300.74RVU15B
2015-01-01$379.15$300.74RVU15A
2014-10-01$379.00$298.91RVU14D
2014-07-01$379.00$298.91RVU14C
2014-04-01$379.00$298.91RVU14B
2014-01-01$379.00$298.91RVU14A
2013-10-01$379.10$294.73RVU13D
2013-07-01$379.10$294.73RVU13C
2013-04-01$379.10$294.73RVU13B
2013-01-01$379.10$294.73RVU13AR

Price 42182 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

42182 billing questions

How do I choose between 42182 and 42180?

Use 42182 for a palatal laceration measuring 2 cm or greater. Code 42180 is for a laceration under 2 cm.

Does the 10-day global period include follow-up visits?

Related postoperative visits during the 10-day global period are included in the procedure.

Can modifier 50 be reported?

No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

When can an assistant-at-surgery claim be paid?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard 50% 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
RVUs for 42182PPRRVU2026_Oct_nonQPP.csv, line 5,003 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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