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

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 Puerto Rico, Medicare pays $330.76 for 42182 in the office and $228.45 when it’s performed in a hospital or facility.

$330.76Office (non-facility)
$228.45Hospital or facility
+0.5%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $330.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

42182 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$330.76
  2. Los Angeles, CA · California$361.96+$31.20
  3. Washington, DC area · District of Columbia$370.77+$40.01
  4. Miami, FL · Florida$364.16+$33.40
  5. Chicago, IL · Illinois$354.16+$23.40
  6. Manhattan, NY · New York$377.60+$46.84
  7. Alaska · Alaska$395.89+$65.13

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

42182 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$298.04$209.49
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

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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 42182 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.77× 1.0003.7700
Practice expense5.54× 1.0115.6009
Malpractice0.54× 0.9850.5319
Total RVUs9.9028
Conversion factor× 33.4009

Office rate, Puerto Rico$330.76

Office: (3.77 × 1 + 5.54 × 1.011 + 0.54 × 0.985) × $33.4009 = $330.76

Facility: (3.77 × 1 + 2.51 × 1.011 + 0.54 × 0.985) × $33.4009 = $228.45

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, Puerto Rico
Same family
42180Palate repair, laceration under 2 cmPalatal laceration repair for wounds under 2 cm.$256.42
Used instead
40830Mouth laceration repair, simple vestibular repairRepair code for a laceration of the oral vestibule rather than the palate.$233.50
40831Laceration repair, complicated vestibular woundAlso addresses oral vestibule lacerations; select by site, not as a palatal repair.$314.85

How 42182 has changed in Puerto Rico

42182 · Office / nonfacility

$330.76

Effective 2026-10-01

The base rate is $10.27 higher than on 2025-10-01, moving from $320.49 to $330.76 (3.2%).

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

    $320.49changed to$330.76

    • 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
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $332.50changed to$320.49

    • 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

    $327.07changed to$332.50

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $339.40changed to$327.07

    • 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
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $338.19changed to$339.40

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $344.54changed to$338.19

    • 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
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $340.74changed to$344.54

    • 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.

  8. January 1, 2021

    RVU21A

    $338.27changed to$340.74

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.94 changed to 5.33
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $334.74changed to$338.27

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. July 1, 2019

    RVU19C

    $334.03changed to$334.74

    • Malpractice RVU 0.53 changed to 0.55

    Held through RVU19D.

  11. January 1, 2019

    RVU19A

    $327.85changed to$334.03

    • 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.

  12. January 1, 2018

    RVU18AR1

    $299.02changed to$327.85

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.80 changed to 4.66
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  13. January 1, 2017

    RVU17A

    $267.72changed to$299.02

    • 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
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  14. January 1, 2016

    RVU16A

    $267.32changed to$267.72

    • 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.

  15. July 1, 2015

    RVU15C

    $265.99changed to$267.32

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  16. January 1, 2015

    RVU15A

    $265.90changed to$265.99

    • 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
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  17. January 1, 2014

    RVU14A

    $261.54changed to$265.90

    • 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
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  18. January 1, 2013

    RVU13AR

    Earliest loaded release: $261.54

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$330.76$228.45RVU26D
2026-07-01$330.76$228.45RVU26C
2026-04-01$330.76$228.45RVU26B
2026-01-01$330.76$228.45RVU26A
2025-10-01$320.49$253.39RVU25D
2025-07-01$320.49$253.39RVU25C
2025-04-01$320.49$253.39RVU25B
2025-01-01$320.49$253.39RVU25A
2024-10-01$332.50$260.09RVU24D
2024-07-01$332.50$260.09RVU24C
2024-04-01$332.50$260.09RVU24B
2024-03-09$332.50$260.09RVU24AR
2024-01-01$327.07$255.85RVU24A
2023-10-01$339.40$263.23RVU23D
2023-07-01$338.19$262.63RVU23C
2023-04-01$338.19$262.63RVU23B
2023-01-01$338.19$262.63RVU23A
2022-10-01$344.54$265.01RVU22D
2022-07-01$344.54$265.01RVU22C
2022-04-01$344.54$265.01RVU22B
2022-01-01$344.54$265.01RVU22A
2021-10-01$340.74$261.95RVU21D
2021-07-01$340.74$261.95RVU21C
2021-04-01$340.74$261.95RVU21B
2021-01-01$340.74$261.95RVU21A
2020-10-01$338.27$265.52RVU20D
2020-07-01$338.27$265.52RVU20C
2020-04-01$338.27$265.52RVU20B
2020-01-01$338.27$265.52RVU20A
2019-10-01$334.74$265.43RVU19D
2019-07-01$334.74$265.43RVU19C
2019-04-01$334.03$264.71RVU19B
2019-01-01$334.03$264.71RVU19A
2018-10-01$327.85$263.32RVU18D
2018-07-01$327.85$263.32RVU18C
2018-04-01$327.85$263.32RVU18B
2018-01-01$327.85$263.32RVU18AR1
2017-10-01$299.02$243.11RVU17D
2017-07-01$299.02$243.11RVU17C
2017-04-01$299.02$243.11RVU17B
2017-01-01$299.02$243.11RVU17A
2016-10-01$267.72$221.03RVU16D
2016-07-01$267.72$221.03RVU16C
2016-04-01$267.72$221.03RVU16B
2016-01-01$267.72$221.03RVU16A
2015-10-01$267.32$221.21RVU15D
2015-07-01$267.32$221.21RVU15C
2015-04-01$265.99$220.11RVU15B
2015-01-01$265.99$220.11RVU15A
2014-10-01$265.90$219.80RVU14D
2014-07-01$265.90$219.80RVU14C
2014-04-01$265.90$219.80RVU14B
2014-01-01$265.90$219.80RVU14A
2013-10-01$261.54$213.79RVU13D
2013-07-01$261.54$213.79RVU13C
2013-04-01$261.54$213.79RVU13B
2013-01-01$261.54$213.79RVU13AR

Price 42182 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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