CPT code 42900: Pharyngeal repair, wound closure2026 Medicare rate & RVUs in Connecticut

In Connecticut, Medicare pays $304.72 for 42900 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42900 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 42900 covers

This service closes a wound in the pharynx with sutures. It is typically performed by an otolaryngologist or another surgeon when a traumatic injury or an operative injury has left pharyngeal tissue requiring repair. The work may take place in a hospital operating room or another setting appropriate to the patient and injury. The record should identify the wound’s location and cause and describe the repair performed.

Report 42900 for wound closure, rather than a reconstructive operation or a procedure whose purpose is control of pharyngeal bleeding. The 10-day global period includes related postoperative visits during that 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of 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 Connecticut compares for 42900

Across 109 of 109 payment localities, the facility rate for 42900 runs from $263.75 in Arkansas to $369.62 in Alaska. Connecticut pays $304.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42900 rates by state

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

See 42900 in every payment locality

How the 42900 rate is calculated

Each of 42900’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 42900

42900 has a 10-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 42900

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

How 42900 has changed in Connecticut

Price 42900 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

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