No office rate
42140 is for excision centered on the uvula. Choose 42145 when the service is a broader palate or pharyngeal repair, such as a uvulopalatopharyngoplasty.
On this page
CMS RVU26D · Effective 2026-10-01
42140 Uvula excision Medicare reimbursement rates in Indiana
Reports surgical removal of uvular tissue, such as an isolated excision for a symptomatic elongated uvula, rather than biopsy or broader palate repair. Compare 42140 office and facility rates across CMS payment localities in Indiana.
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.
What does Medicare pay for 42140 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$283.35
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$141.54
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Otolaryngology surgery
About 42140: Uvula excision
Reports surgical removal of uvular tissue, such as an isolated excision for a symptomatic elongated uvula, rather than biopsy or broader palate repair.
An otolaryngologist removes uvular tissue when the uvula itself is the target of treatment, such as an isolated excision for symptomatic elongation or irritation. The procedure may be performed in an operating room or an appropriately equipped procedure setting, depending on the planned surgery and patient. When uvular removal is part of a broader palate and pharyngeal operation, the overall procedure may be represented by a different code rather than an isolated excision.
Select 42140 when the operative service is excision of the uvula, not merely sampling a lesion or destroying it. The operative note should identify the uvula as the site, describe the tissue removed, and establish the reason for excision. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 42140
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.66 · 18%
- Practice expense (office) RVU7.24 · 79%
- Malpractice RVU0.23 · 3%
294
Medicare services in 2024 · #4005 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.
42140 compared with similar codes
Office rates for Indiana, from the same CMS release.
$139.61
42100 describes biopsy of the palate for diagnostic sampling; 42140 represents excision of uvular tissue as treatment.
$216.65
42160 is for treatment of a mouth-roof lesion by destruction. 42140 is used when uvular tissue is surgically excised.
No office rate
42120 is relevant to a more extensive palate resection. 42140 is limited to excision of the uvula.
Compare 42140 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Indiana →
Office / nonfacility
$283.35
Facility
$141.54
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 42140 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
4,999
- Code
- 42140
- Physician work
- 1.66
- Practice expense
- 7.24
- Malpractice
- 0.23
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.66 | × 1.000 | 1.6600 |
| Practice expense | 7.24 | × 0.927 | 6.7115 |
| Malpractice | 0.23 | × 0.486 | 0.1118 |
| Total RVUs | 8.4833 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$283.35
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.66 | 1 |
| Practice expense | 7.24 | 0.927 |
| Malpractice | 0.23 | 0.486 |
(1.66 × 1 + 7.24 × 0.927 + 0.23 × 0.486) × $33.4009 = $283.35
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.66 | 1 |
| Practice expense | 2.66 | 0.927 |
| Malpractice | 0.23 | 0.486 |
(1.66 × 1 + 2.66 × 0.927 + 0.23 × 0.486) × $33.4009 = $141.54
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.
42140 billing questions
When should 42140 be chosen instead of 42145?
Use 42140 for excision focused on the uvula. When the operation includes broader palate or pharyngeal repair, evaluate 42145 instead of treating the uvular work as a separate service automatically.
Can 42140 be reported with a biopsy code?
A diagnostic sampling service and a therapeutic excision are different services. The record should show that a distinct biopsy was performed; do not report a biopsy merely because the excised tissue was sent for pathology.
Is modifier 50 appropriate for this code?
No. The CMS bilateral adjustment does not apply to 42140, and modifier 50 is inappropriate for this anatomy and descriptor.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid?
CMS applies a statutory restriction to assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
How is 42140 affected when other procedures are done 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% when performed in the same session.
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.
4,99642107,,Excision lesion mouth roof,A,,4.45,9.05,,4.08,,0.59,14.09,9.12,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9974210F,,Ace/arb thxpy for mos/>,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
4,99842120,,Remove palate/lesion,A,,11.56,14.06,NA,14.06,,1.69,27.31,27.31,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,99942140,,Excision of uvula,A,,1.66,7.24,,2.66,,0.23,9.13,4.55,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,00042145,,Repair palate pharynx/uvula,A,,9.54,7.29,NA,7.29,,1.39,18.22,18.22,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,00142160,,Treatment mouth roof lesion,A,,1.80,4.94,,1.84,,0.22,6.96,3.86,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,00242180,,Repair lac palate<2 cm,A,,2.49,4.78,,2.20,,0.36,7.63,5.05,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915