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CMS RVU26D · Effective 2026-10-01

42810 in Wyoming**

Office / nonfacility

$382.03

Base rate per service

Facility setting

$253.77

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.

ENT surgery

About 42810: Superficial branchial cleft remnant excision

Reports removal of a superficial branchial cleft cyst or remnant confined to the skin and subcutaneous tissue, without deeper extension.

This code describes surgical removal of a branchial cleft cyst or remnant when it is limited to the skin and tissue just beneath it. Otolaryngologists and other surgeons may perform the procedure for a congenital neck lump or draining opening attributable to a superficial branchial cleft remnant. The operative report should identify the lesion and its location and show that its extent remained within the skin and subcutaneous tissues.

Choose this code based on the documented depth and extent, not simply the diagnosis of a neck cyst. A remnant extending deeper than the subcutaneous tissues or into the pharynx points to 42815 instead. The procedure has 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. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons and team surgery are not permitted.

CMS billing rules for 42810

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 procedure with modifier 50 is paid at 150%.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.30 · 29%
  • Practice expense (office) RVU7.79 · 67%
  • Malpractice RVU0.47 · 4%

45

Medicare services in 2024 · #5421 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.

42810 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

42815

Neck cyst excision

Extending below hyoid

No office rate

Both address branchial cleft cysts or remnants, but 42810 is limited to lesions within skin and subcutaneous tissue. Deeper extension or extension into the pharynx is the distinguishing feature for 42815.

60281

Duct lesion excision

With hyoid bone resection

No office rate

Use 60281 for a primary thyroglossal duct cyst or sinus. A branchial cleft cyst or remnant confined to skin and subcutaneous tissue is reported with 42810.

21555

Mass excision

Subcutaneous, under 3 cm

$455.48

This code is for a qualifying soft-tissue mass of the neck, not a branchial cleft remnant. The documented diagnosis and operative findings determine which service applies.

The same code, a different location

How does Wyoming** compare?

42810 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $382.03

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $432.97

    $50.94 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $440.15

    $58.12 higher than Wyoming**

  4. Miami

    $420.79

    $38.76 higher than Wyoming**

  5. Chicago

    $408.52

    $26.49 higher than Wyoming**

  6. Manhattan

    $444.52

    $62.49 higher than Wyoming**

  7. Alaska*

    $451.09

    $69.06 higher than Wyoming**

Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 42810 ranges from $341.81 in Arkansas to $505.96 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Alabama

    Alabama · 42810

    Office

    $346.78

    Facility

    $234.55

    $35.25 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 42810

    Office

    $341.81

    Facility

    $231.64

    $40.22 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 42810

    Office

    $375.79

    Facility

    $251.50

    $6.24 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 42810

    Office

    $407.05

    Facility

    $266.48

    $25.02 higher than Wyoming** for the office setting.

  • Chico

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • El Centro

    California · 42810

    Office

    $405.76

    Facility

    $265.19

    $23.73 higher than Wyoming** for the office setting.

  • Fresno

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Madera

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Merced

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Modesto

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Napa

    California · 42810

    Office

    $468.08

    Facility

    $299.03

    $86.05 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 42810

    Office

    $430.64

    Facility

    $279.03

    $48.61 higher than Wyoming** for the office setting.

  • Redding

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 42810

    Office

    $410.77

    Facility

    $270.20

    $28.74 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 42810

    Office

    $425.21

    Facility

    $276.04

    $43.18 higher than Wyoming** for the office setting.

  • Salinas

    California · 42810

    Office

    $423.62

    Facility

    $274.97

    $41.59 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 42810

    Office

    $433.23

    Facility

    $279.83

    $51.20 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 42810

    Office

    $494.77

    Facility

    $313.93

    $112.74 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 42810

    Office

    $494.24

    Facility

    $313.39

    $112.21 higher than Wyoming** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 42810

    Office

    $505.96

    Facility

    $321.01

    $123.93 higher than Wyoming** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 42810

    Office

    $503.78

    Facility

    $318.83

    $121.75 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 42810

    Office

    $416.87

    Facility

    $270.78

    $34.84 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 42810

    Office

    $437.09

    Facility

    $281.25

    $55.06 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 42810

    Office

    $425.11

    Facility

    $275.56

    $43.08 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 42810

    Office

    $441.46

    Facility

    $283.96

    $59.43 higher than Wyoming** for the office setting.

  • Stockton

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Vallejo

    California · 42810

    Office

    $467.31

    Facility

    $298.26

    $85.28 higher than Wyoming** for the office setting.

  • Visalia

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Yuba City

    California · 42810

    Office

    $405.68

    Facility

    $265.11

    $23.65 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 42810

    Office

    $400.65

    Facility

    $264.18

    $18.62 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 42810

    Office

    $411.65

    Facility

    $273.51

    $29.62 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 42810

    Office

    $381.96

    Facility

    $255.24

    $0.07 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 42810

    Office

    $402.18

    Facility

    $272.25

    $20.15 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 42810

    Office

    $382.56

    Facility

    $259.95

    $0.53 higher than Wyoming** for the office setting.

  • Atlanta

    Georgia · 42810

    Office

    $393.76

    Facility

    $263.45

    $11.73 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 42810

    Office

    $361.03

    Facility

    $246.62

    $21.00 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 42810

    Office

    $415.15

    Facility

    $269.32

    $33.12 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 42810

    Office

    $354.53

    Facility

    $237.17

    $27.50 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 42810

    Office

    $357.03

    Facility

    $239.03

    $25.00 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 42810

    Office

    $381.22

    Facility

    $263.22

    $0.81 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 42810

    Office

    $372.32

    Facility

    $255.21

    $9.71 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 42810

    Office

    $406.03

    Facility

    $274.31

    $24.00 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 42810

    Office

    $359.05

    Facility

    $240.15

    $22.98 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 42810

    Office

    $353.35

    Facility

    $237.40

    $28.68 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 42810

    Office

    $355.90

    Facility

    $241.88

    $26.13 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 42810

    Office

    $372.90

    Facility

    $252.21

    $9.13 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 42810

    Office

    $355.53

    Facility

    $242.02

    $26.50 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 42810

    Office

    $439.38

    Facility

    $286.24

    $57.35 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 42810

    Office

    $398.48

    Facility

    $263.42

    $16.45 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 42810

    Office

    $410.59

    Facility

    $272.97

    $28.56 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 42810

    Office

    $389.05

    Facility

    $259.25

    $7.02 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 42810

    Office

    $359.36

    Facility

    $241.37

    $22.67 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 42810

    Office

    $377.98

    Facility

    $250.87

    $4.05 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 42810

    Office

    $387.78

    Facility

    $264.01

    $5.75 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 42810

    Office

    $365.50

    Facility

    $248.40

    $16.53 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 42810

    Office

    $382.61

    Facility

    $250.63

    $0.58 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 42810

    Office

    $369.88

    Facility

    $249.45

    $12.15 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 42810

    Office

    $373.66

    Facility

    $251.55

    $8.37 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 42810

    Office

    $349.80

    Facility

    $239.24

    $32.23 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 42810

    Office

    $345.85

    Facility

    $235.42

    $36.18 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 42810

    Office

    $386.08

    Facility

    $257.82

    $4.05 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 42810

    Office

    $363.01

    Facility

    $243.35

    $19.02 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 42810

    Office

    $376.79

    Facility

    $248.53

    $5.24 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 42810

    Office

    $356.32

    Facility

    $237.93

    $25.71 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 42810

    Office

    $394.82

    Facility

    $261.30

    $12.79 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 42810

    Office

    $435.76

    Facility

    $286.98

    $53.73 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 42810

    Office

    $415.98

    Facility

    $275.92

    $33.95 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 42810

    Office

    $367.67

    Facility

    $250.06

    $14.36 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 42810

    Office

    $383.75

    Facility

    $255.37

    $1.72 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 42810

    Office

    $455.80

    Facility

    $303.30

    $73.77 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 42810

    Office

    $419.09

    Facility

    $278.65

    $37.06 higher than Wyoming** for the office setting.

  • Queens

    New York · 42810

    Office

    $447.46

    Facility

    $295.86

    $65.43 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 42810

    Office

    $368.44

    Facility

    $246.60

    $13.59 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 42810

    Office

    $363.60

    Facility

    $246.50

    $18.43 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 42810

    Office

    $354.77

    Facility

    $240.24

    $27.26 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 42810

    Office

    $412.74

    Facility

    $270.24

    $30.71 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 42810

    Office

    $380.41

    Facility

    $252.66

    $1.62 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 42810

    Office

    $401.80

    Facility

    $268.28

    $19.77 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 42810

    Office

    $363.92

    Facility

    $246.17

    $18.11 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 42810

    Office

    $388.74

    Facility

    $259.07

    $6.71 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 42810

    Office

    $395.10

    Facility

    $262.61

    $13.07 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 42810

    Office

    $363.98

    Facility

    $245.47

    $18.05 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 42810

    Office

    $375.69

    Facility

    $247.43

    $6.34 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 42810

    Office

    $355.17

    Facility

    $238.58

    $26.86 lower than Wyoming** for the office setting.

  • Austin

    Texas · 42810

    Office

    $399.64

    Facility

    $263.94

    $17.61 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 42810

    Office

    $361.58

    Facility

    $244.87

    $20.45 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 42810

    Office

    $381.20

    Facility

    $254.10

    $0.83 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 42810

    Office

    $383.84

    Facility

    $256.09

    $1.81 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 42810

    Office

    $381.44

    Facility

    $254.97

    $0.59 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 42810

    Office

    $382.47

    Facility

    $255.11

    $0.44 higher than Wyoming** for the office setting.

  • Houston

    Texas · 42810

    Office

    $391.08

    Facility

    $263.72

    $9.05 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 42810

    Office

    $371.32

    Facility

    $249.60

    $10.71 lower than Wyoming** for the office setting.

  • Utah

    Utah · 42810

    Office

    $368.90

    Facility

    $248.34

    $13.13 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 42810

    Office

    $377.08

    Facility

    $251.00

    $4.95 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 42810

    Office

    $388.74

    Facility

    $259.07

    $6.71 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 42810

    Office

    $375.76

    Facility

    $248.78

    $6.27 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 42810

    Office

    $397.59

    Facility

    $262.53

    $15.56 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 42810

    Office

    $447.82

    Facility

    $290.44

    $65.79 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 42810

    Office

    $364.32

    Facility

    $241.45

    $17.71 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 42810

    Office

    $358.80

    Facility

    $247.34

    $23.23 lower than Wyoming** for the office setting.

See how rates vary across the country

42810 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$341.81

$455.82

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$451.091
AL$346.781
AR$341.811
AZ$375.791
CA$405.68–$505.9629
CO$400.651
CT$411.651
DC$440.151
DE$381.961
FL$382.56–$420.793
GA$361.03–$393.762
GU$415.151
HI$415.151
IA$354.531
ID$357.031
IL$372.32–$408.524
IN$359.051
KS$353.351
KY$355.901
LA$355.53–$372.902
MA$398.48–$439.382
MD$389.05–$440.153
ME$359.36–$377.982
MI$365.50–$387.782
MN$382.611
MO$349.80–$373.663
MS$345.851
MT$386.081
NC$363.011
ND$376.791
NE$356.321
NH$394.821
NJ$415.98–$435.762
NM$367.671
NV$383.751
NY$368.44–$455.805
OH$363.601
OK$354.771
OR$380.41–$412.742
PA$363.92–$401.802
PR$388.741
RI$395.101
SC$363.981
SD$375.691
TN$355.171
TX$361.58–$399.648
UT$368.901
VA$377.08–$440.152
VI$388.741
VT$375.761
WA$397.59–$447.822
WI$364.321
WV$358.801
WY$382.031

Explore 42810 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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.

Browse all communities in Wyoming →

Why are the office and facility amounts different?

For 42810 in Wyoming**, the physician’s office rate is $382.03 and the facility-setting rate is $253.77: a difference of $128.26.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 42810 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$420.23

$382.03 × 110% = $420.23

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.

Compare your contract offer →

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 42810 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

5,077

Code
42810
Physician work
3.30
Practice expense
7.79
Malpractice
0.47

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 42810 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work3.30× 1.0003.3000
Practice expense7.79× 1.0007.7900
Malpractice0.47× 0.7400.3478
Total RVUs11.4378
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$382.03

Open 42810 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.31
Practice expense7.791
Malpractice0.470.74

(3.3 × 1 + 7.79 × 1 + 0.47 × 0.74) × $33.4009 = $382.03

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.31
Practice expense3.951
Malpractice0.470.74

(3.3 × 1 + 3.95 × 1 + 0.47 × 0.74) × $33.4009 = $253.77

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

42810 · Office / nonfacility

$382.03

Effective 2026-10-01

The base rate is $7.15 higher than on 2025-10-01, moving from $374.88 to $382.03 (1.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $374.88changed to$382.03

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.38 changed to 3.30
    • Practice expense RVU 7.84 changed to 7.79
    • Malpractice RVU 0.50 changed to 0.47
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $374.88

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$382.03$253.77RVU26D
2026-07-01$382.03$253.77RVU26C
2026-04-01$382.03$253.77RVU26B
2026-01-01$382.03$253.77RVU26A
2025-10-01$374.88$274.93RVU25D
2025-07-01$374.88$274.93RVU25C
2025-04-01$374.88$274.93RVU25B
2025-01-01$374.88$274.93RVU25A

42810 billing questions

How do I distinguish 42810 from 42815?

Use 42810 when the branchial cleft cyst or remnant is confined to skin and subcutaneous tissue. Use 42815 when the operative documentation describes extension beneath the subcutaneous tissues or into the pharynx.

What documentation supports 42810?

Document the branchial cleft origin, neck location, and operative findings showing the lesion remained within skin and subcutaneous tissue. The depth and extent of the excision distinguish this code from 42815.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is 42810 handled with another procedure in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Can modifier 50 be used for bilateral excision?

The CMS bilateral rule specifies modifier 50, with payment at 150% for a bilateral procedure.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons and team surgery are not permitted for this code.

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.

RVUs for 42810PPRRVU2026_Oct_nonQPP.csv, line 5,077 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet