CPT code 42842: Throat resection, without closure2026 Medicare rate & RVUs in Montana

In Montana, Medicare pays $910.72 for 42842 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42842 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 42842 covers

An otolaryngologist or head and neck surgeon uses this code for an extensive resection involving the tonsil, tonsillar pillars, and/or pharyngeal walls, commonly to remove an oropharyngeal malignancy. It describes a substantially wider operation than taking a biopsy or removing a discrete, limited pharyngeal lesion. The operative report should identify the structures and extent of tissue removed and state that the resulting area was left without closure.

Report this code when the documented operation matches that extent and closure status; a limited lesion excision or a resection closed primarily or reconstructed points to a different code. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 Montana compares for 42842

Across 109 of 109 payment localities, the facility rate for 42842 runs from $818.21 in Arkansas to $1,127.69 in San Benito County, CA. Montana pays $910.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42842 rates by state

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

See 42842 in every payment locality

How the 42842 rate is calculated

Each of 42842’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 42842

42842 has a 90-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 42842

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

How 42842 has changed in Montana

Price 42842 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

• Absarokee
• Acton
• Alberton
• Alder
• Alzada
• Amsterdam
• Anaconda-Deer Lodge County
• Antelope

Browse all communities in Montana

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