CPT code 42955: Pharyngotomy, foreign body exploration2026 Medicare rate & RVUs in Nevada

In Nevada, Medicare pays $690.78 for 42955 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42955 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 42955 covers

An otolaryngologist or head-and-neck surgeon uses this service to open the pharynx for operative exploration or removal of a foreign body. It is generally performed in an operating room when the target cannot be managed through a less invasive route. The operative note should identify the pharyngeal site, the reason for opening it, the exploration or removal performed, and the method of closure.

Report 42955 for the pharyngotomy itself, not for repair of a traumatic pharyngeal wound or for reconstructive surgery. Routine closure of the surgical opening is part of the service. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care 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% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 Nevada compares for 42955

Across 109 of 109 payment localities, the facility rate for 42955 runs from $622.18 in Arkansas to $883.60 in San Benito County, CA. Nevada pays $690.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42955 rates by state

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

See 42955 in every payment locality

How the 42955 rate is calculated

Each of 42955’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 42955

42955 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 42955

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

How 42955 has changed in Nevada

Price 42955 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

• Alamo
• Amargosa Valley
• Austin
• Baker
• Battle Mountain
• Beatty
• Beaverdam
• Bennett Springs

Browse all communities in Nevada

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