CPT code 42844: Throat resection, with closure2026 Medicare rate & RVUs in Texas
Reports radical removal of tissue in the tonsillar or retromolar region when the surgical defect is closed as part of the operation.
CMS doesn’t publish an office rate for 42844 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 42844 covers
An otolaryngologist or head and neck surgeon may use this operation to remove extensive disease involving the tonsil, tonsillar pillars, or retromolar trigone, commonly in cancer surgery. The resection includes closure of the resulting defect. The operative report should identify the structures and extent removed and describe how the defect was closed; the closure distinguishes this service from the corresponding radical resection without closure.
Report this code when the documented extent of resection and closure support this level rather than a limited pharyngeal lesion excision or a more extensive flap-closure service. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 42844 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,252.31 |
| Beaumont, TX | Unavailable | $1,171.70 |
| Brazoria, TX | Unavailable | $1,208.88 |
| Dallas, TX | Unavailable | $1,219.07 |
| Fort Worth, TX | Unavailable | $1,214.58 |
| Galveston, TX | Unavailable | $1,214.19 |
| Houston, TX | Unavailable | $1,261.96 |
| Rest of Texas | Unavailable | $1,191.36 |
How the 42844 rate is calculated
Each of 42844’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 · 42844
RVUs × geographic indexes × conversion factor
Work17.34
17.34 RVUs× 1.000 GPCI
Practice expense16.83
16.83 RVUs× 1.000 GPCI
Malpractice2.61
2.61 RVUs× 1.000 GPCI
Adjusted RVUs
36.7800
Conversion factor
$33.4009
Medicare rate
$1,228.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42844
42844 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42844
Throat resection, with closure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 42844
Throat resection, with closure
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42844 without 51 · national facility
$1,228.49
Throat resection, with closure
42844-51 · Second procedure: 50%
$614.25
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%).
42844 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 42842Throat resectionWithout closure
- Both describe radical resection in the tonsillar or retromolar region. Choose 42844 when the defect is closed; 42842 represents resection without closure.
- 42845Throat resectionFree skin graft closure
- This related radical resection code specifies closure using a flap. 42844 represents closure without that flap distinction.
- 42808Pharyngeal lesion treatmentExcision or destruction
- 42808 is for excision of a pharyngeal lesion, not the radical resection with closure represented by 42844.
- 42890PharyngectomyLimited resection
- 42890 describes a limited pharyngectomy. 42844 is selected for the specified radical resection of tonsillar, pillar, or retromolar tissue with closure.
42844 billing questions
How does 42844 differ from 42842?
42844 includes closure of the defect after the radical resection. 42842 is the corresponding radical resection without closure.
When would 42845 be more appropriate?
Use 42845 when the defect is closed using a flap. 42844 describes closure without that flap distinction.
Can the closure be reported separately?
Closure is part of the service represented by 42844. The operative report should describe it to support choosing this code rather than 42842.
What documentation supports 42844?
Document the structures and extent removed, the radical nature of the resection, and how the surgical defect was closed.
How does the 90-day global affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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