CPT code 42845: Throat resection, free skin graft closure2026 Medicare rate & RVUs in Utah

In Utah, Medicare pays $1,871.23 for 42845 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42845 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 42845 covers

An otolaryngologist or head-and-neck surgeon may report this extensive operation for disease involving the tonsil, tonsillar pillars, or retromolar trigone. The surgeon removes the involved tissue and closes the resulting defect using a free skin graft. It is typically performed in an operating room, often for an extensive oropharyngeal tumor that cannot be managed with a limited lesion excision. The operative report should identify the resected structures and describe the graft closure.

Choose this code when the documented resection and closure meet this extensive procedure level; a smaller excision or a resection closed without a free skin graft belongs to a different code. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. 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.

How Utah compares for 42845

Across 109 of 109 payment localities, the facility rate for 42845 runs from $1,754.00 in Arkansas to $2,437.00 in Alaska. Utah pays $1,871.23. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42845 rates by state

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

See 42845 in every payment locality

How the 42845 rate is calculated

Each of 42845’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 42845

42845 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 42845

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

How 42845 has changed in Utah

Price 42845 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

• Alpine
• Alta
• Altamont
• Alton
• Amalga
• American Fork
• Aneth
• Annabella

Browse all communities in Utah

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