No office rate
42900 is for suture closure of a pharyngeal wound. 42950 is used for a reconstructive operation on the pharynx.
On this page
CMS RVU26D · Effective 2026-10-01
42900 in Chico
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$288.82
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Otolaryngology surgery
About 42900: Suture repair of pharyngeal wound
Reports surgical closure of a wound in the pharynx, such as a traumatic or procedural laceration requiring suture repair.
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.
CMS billing rules for 42900
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.16 · 60%
- Practice expense (office) RVU2.73 · 32%
- Malpractice RVU0.76 · 9%
51
Medicare services in 2024 · #5345 by national volume
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.
42900 compared with similar codes
Office rates for Chico, from the same CMS release.
No office rate
Choose 42953 when the repair involves the pharynx and esophagus; 42900 describes closure of a pharyngeal wound.
No office rate
42960 addresses control of pharyngeal or nasopharyngeal bleeding. Use 42900 when the service is suturing a pharyngeal wound.
42999
No office rateUnlisted px phrnx adnd/tnsl
Use 42900 when its wound-closure service fits. 42999 is for a pharyngeal procedure without a more specific listed code.
The same code, a different location
How does Chico compare?
42900 across payment areas
Same release and payment basis · bars start at $0
Chico · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 42900
Office
Unavailable
Facility
$288.82
No comparable office rate is available.
Modesto
California · 42900
Office
Unavailable
Facility
$288.82
No comparable office rate is available.
Napa
California · 42900
Office
Unavailable
Facility
$316.28
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 42900
Office
Unavailable
Facility
$300.77
No comparable office rate is available.
Redding
California · 42900
Office
Unavailable
Facility
$288.82
No comparable office rate is available.
Rest Of California
California · 42900
Office
Unavailable
Facility
$288.82
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 42900
Office
Unavailable
Facility
$297.04
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 42900
Office
Unavailable
Facility
$298.21
No comparable office rate is available.
Salinas
California · 42900
Office
Unavailable
Facility
$296.98
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 42900
Office
Unavailable
Facility
$300.33
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 42900
Office
Unavailable
Facility
$328.94
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 42900
Office
Unavailable
Facility
$328.08
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 42900
Office
Unavailable
Facility
$336.40
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 42900
Office
Unavailable
Facility
$332.87
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 42900
Office
Unavailable
Facility
$292.74
No comparable office rate is available.
Santa Cruz-Watsonville
California · 42900
Office
Unavailable
Facility
$300.36
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 42900
Office
Unavailable
Facility
$297.10
No comparable office rate is available.
Santa Rosa-Petaluma
California · 42900
Office
Unavailable
Facility
$303.10
No comparable office rate is available.
Stockton
California · 42900
Office
Unavailable
Facility
$288.82
No comparable office rate is available.
Vallejo
California · 42900
Office
Unavailable
Facility
$315.04
No comparable office rate is available.
Visalia
California · 42900
Office
Unavailable
Facility
$288.82
No comparable office rate is available.
Yuba City
California · 42900
Office
Unavailable
Facility
$288.82
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 42900
Office
Unavailable
Facility
$317.32
No comparable office rate is available.
Miami
Florida · 42900
Office
Unavailable
Facility
$331.47
No comparable office rate is available.
Chicago
Illinois · 42900
Office
Unavailable
Facility
$323.45
No comparable office rate is available.
Manhattan
New York · 42900
Office
Unavailable
Facility
$329.60
No comparable office rate is available.
Alaska*
Alaska · 42900
Office
Unavailable
Facility
$369.62
No comparable office rate is available.
Alabama
Alabama · 42900
Office
Unavailable
Facility
$266.50
No comparable office rate is available.
Arkansas
Arkansas · 42900
Office
Unavailable
Facility
$263.75
No comparable office rate is available.
Arizona
Arizona · 42900
Office
Unavailable
Facility
$282.44
No comparable office rate is available.
Colorado
Colorado · 42900
Office
Unavailable
Facility
$291.26
No comparable office rate is available.
Connecticut
Connecticut · 42900
Office
Unavailable
Facility
$304.72
No comparable office rate is available.
Delaware
Delaware · 42900
Office
Unavailable
Facility
$286.12
No comparable office rate is available.
Fort Lauderdale
Florida · 42900
Office
Unavailable
Facility
$310.61
No comparable office rate is available.
Rest Of Florida
Florida · 42900
Office
Unavailable
Facility
$297.67
No comparable office rate is available.
Atlanta
Georgia · 42900
Office
Unavailable
Facility
$296.00
No comparable office rate is available.
Rest Of Georgia
Georgia · 42900
Office
Unavailable
Facility
$283.94
No comparable office rate is available.
Hawaii, Guam
Hawaii · 42900
Office
Unavailable
Facility
$290.72
No comparable office rate is available.
Iowa
Iowa · 42900
Office
Unavailable
Facility
$265.86
No comparable office rate is available.
Idaho
Idaho · 42900
Office
Unavailable
Facility
$268.25
No comparable office rate is available.
East St. Louis
Illinois · 42900
Office
Unavailable
Facility
$307.36
No comparable office rate is available.
Rest Of Illinois
Illinois · 42900
Office
Unavailable
Facility
$295.28
No comparable office rate is available.
Suburban Chicago
Illinois · 42900
Office
Unavailable
Facility
$312.18
No comparable office rate is available.
Indiana
Indiana · 42900
Office
Unavailable
Facility
$269.21
No comparable office rate is available.
Kansas
Kansas · 42900
Office
Unavailable
Facility
$267.57
No comparable office rate is available.
Kentucky
Kentucky · 42900
Office
Unavailable
Facility
$276.64
No comparable office rate is available.
New Orleans
Louisiana · 42900
Office
Unavailable
Facility
$286.99
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 42900
Office
Unavailable
Facility
$277.37
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 42900
Office
Unavailable
Facility
$310.88
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 42900
Office
Unavailable
Facility
$291.36
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 42900
Office
Unavailable
Facility
$304.35
No comparable office rate is available.
Rest Of Maryland
Maryland · 42900
Office
Unavailable
Facility
$289.65
No comparable office rate is available.
Rest Of Maine
Maine · 42900
Office
Unavailable
Facility
$272.03
No comparable office rate is available.
Southern Maine
Maine · 42900
Office
Unavailable
Facility
$278.73
No comparable office rate is available.
Detroit
Michigan · 42900
Office
Unavailable
Facility
$303.14
No comparable office rate is available.
Rest Of Michigan
Michigan · 42900
Office
Unavailable
Facility
$284.26
No comparable office rate is available.
Minnesota
Minnesota · 42900
Office
Unavailable
Facility
$273.69
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 42900
Office
Unavailable
Facility
$282.77
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 42900
Office
Unavailable
Facility
$284.59
No comparable office rate is available.
Rest Of Missouri
Missouri · 42900
Office
Unavailable
Facility
$275.67
No comparable office rate is available.
Mississippi
Mississippi · 42900
Office
Unavailable
Facility
$269.62
No comparable office rate is available.
Montana**
Montana · 42900
Office
Unavailable
Facility
$288.87
No comparable office rate is available.
North Carolina
North Carolina · 42900
Office
Unavailable
Facility
$273.64
No comparable office rate is available.
North Dakota**
North Dakota · 42900
Office
Unavailable
Facility
$273.84
No comparable office rate is available.
Nebraska
Nebraska · 42900
Office
Unavailable
Facility
$266.11
No comparable office rate is available.
New Hampshire
New Hampshire · 42900
Office
Unavailable
Facility
$289.48
No comparable office rate is available.
Northern Nj
New Jersey · 42900
Office
Unavailable
Facility
$316.09
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 42900
Office
Unavailable
Facility
$306.66
No comparable office rate is available.
New Mexico
New Mexico · 42900
Office
Unavailable
Facility
$286.45
No comparable office rate is available.
Nevada**
Nevada · 42900
Office
Unavailable
Facility
$284.77
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 42900
Office
Unavailable
Facility
$338.94
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 42900
Office
Unavailable
Facility
$310.67
No comparable office rate is available.
Queens
New York · 42900
Office
Unavailable
Facility
$327.76
No comparable office rate is available.
Rest Of New York
New York · 42900
Office
Unavailable
Facility
$276.82
No comparable office rate is available.
Ohio
Ohio · 42900
Office
Unavailable
Facility
$281.19
No comparable office rate is available.
Oklahoma
Oklahoma · 42900
Office
Unavailable
Facility
$273.50
No comparable office rate is available.
Portland
Oregon · 42900
Office
Unavailable
Facility
$295.30
No comparable office rate is available.
Rest Of Oregon
Oregon · 42900
Office
Unavailable
Facility
$281.01
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 42900
Office
Unavailable
Facility
$300.66
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 42900
Office
Unavailable
Facility
$280.04
No comparable office rate is available.
Puerto Rico
Puerto Rico · 42900
Office
Unavailable
Facility
$289.54
No comparable office rate is available.
Rhode Island
Rhode Island · 42900
Office
Unavailable
Facility
$292.46
No comparable office rate is available.
South Carolina
South Carolina · 42900
Office
Unavailable
Facility
$278.18
No comparable office rate is available.
South Dakota**
South Dakota · 42900
Office
Unavailable
Facility
$272.06
No comparable office rate is available.
Tennessee
Tennessee · 42900
Office
Unavailable
Facility
$268.87
No comparable office rate is available.
Austin
Texas · 42900
Office
Unavailable
Facility
$291.66
No comparable office rate is available.
Beaumont
Texas · 42900
Office
Unavailable
Facility
$278.91
No comparable office rate is available.
Brazoria
Texas · 42900
Office
Unavailable
Facility
$283.89
No comparable office rate is available.
Dallas
Texas · 42900
Office
Unavailable
Facility
$286.50
No comparable office rate is available.
Fort Worth
Texas · 42900
Office
Unavailable
Facility
$285.92
No comparable office rate is available.
Galveston
Texas · 42900
Office
Unavailable
Facility
$285.29
No comparable office rate is available.
Houston
Texas · 42900
Office
Unavailable
Facility
$299.20
No comparable office rate is available.
Rest Of Texas
Texas · 42900
Office
Unavailable
Facility
$281.81
No comparable office rate is available.
Utah
Utah · 42900
Office
Unavailable
Facility
$280.86
No comparable office rate is available.
Virginia
Virginia · 42900
Office
Unavailable
Facility
$279.90
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 42900
Office
Unavailable
Facility
$289.54
No comparable office rate is available.
Vermont
Vermont · 42900
Office
Unavailable
Facility
$275.47
No comparable office rate is available.
Rest Of Washington
Washington · 42900
Office
Unavailable
Facility
$289.92
No comparable office rate is available.
Seattle (King Cnty)
Washington · 42900
Office
Unavailable
Facility
$313.59
No comparable office rate is available.
Wisconsin
Wisconsin · 42900
Office
Unavailable
Facility
$267.52
No comparable office rate is available.
West Virginia
West Virginia · 42900
Office
Unavailable
Facility
$287.91
No comparable office rate is available.
Wyoming**
Wyoming · 42900
Office
Unavailable
Facility
$282.32
No comparable office rate is available.
See how rates vary across the country
42900 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 42900 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$317.70
$288.82 × 110% = $317.70
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 42900 in Chico.
PPRRVU2026_Oct_nonQPP.csv
5,095
- Code
- 42900
- Physician work
- 5.16
- Practice expense
- 2.73
- Malpractice
- 0.76
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.16 | × 1.017 | 5.2477 |
| Practice expense | 2.73 | × 1.096 | 2.9921 |
| Malpractice | 0.76 | × 0.536 | 0.4074 |
| Total RVUs | 8.6472 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Chico$288.82
Open 42900 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.16 | 1.017 |
| Practice expense | 2.73 | 1.096 |
| Malpractice | 0.76 | 0.536 |
(5.16 × 1.017 + 2.73 × 1.096 + 0.76 × 0.536) × $33.4009 = $288.82
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
42900 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $288.82 | RVU26D |
| 2026-07-01 | Not available in this setting | $288.82 | RVU26C |
| 2026-04-01 | Not available in this setting | $288.82 | RVU26B |
| 2026-01-01 | Not available in this setting | $288.82 | RVU26A |
| 2025-10-01 | Not available in this setting | $327.81 | RVU25D |
| 2025-07-01 | Not available in this setting | $327.81 | RVU25C |
| 2025-04-01 | Not available in this setting | $327.81 | RVU25B |
| 2025-01-01 | Not available in this setting | $327.81 | RVU25A |
42900 billing questions
When should 42900 be chosen over 42950?
Use 42900 for sutured closure of a pharyngeal wound. Code 42950 describes a reconstructive operation on the pharynx, not routine wound closure.
Does 42900 include related postoperative visits?
Yes. Its 10-day global period includes related postoperative visits during the 10 days after the procedure.
How does the multiple-procedure rule affect 42900?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% reduction.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 42900?
Document the pharyngeal wound’s location and cause, and describe the suture repair performed. The record should make clear that the service was wound closure rather than reconstruction or bleeding control.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,09242890,,Limited pharyngectomy,A,,18.65,16.17,NA,16.17,,2.76,37.58,37.58,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,09342892,,Revision of pharyngeal walls,A,,25.38,20.06,NA,20.06,,3.70,49.14,49.14,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,09442894,,Revision of pharyngeal walls,A,,33.07,24.14,NA,24.14,,4.84,62.05,62.05,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,09542900,,Repair throat wound,A,,5.16,2.73,NA,2.73,,0.76,8.65,8.65,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0964290F,,Pt scrned for inj drug use,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0974293F,,Pt scrnd hgh-risk sex behav,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,09842950,,Reconstruction of throat,A,,8.06,12.69,NA,12.69,,1.20,21.95,21.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536