42104 Excision lesion mouth roof
Also known as: palatal lesion excision, palate lesion removal
Surgical excision and removal of a small lesion from the palate with closure of the defect. Appropriate for lesions requiring tissue diagnosis and removal.
In Plain Language
removal of small growth or sore from roof of mouth; palate lesion surgery
Clinical Context
Surgical procedure for benign or malignant lesions of the palate including papillomas, cysts, ulcers, or suspicious lesions requiring excision and histopathology.
RVU Breakdown
| Work RVU | 1.65 |
| Total RVU | 1.65 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 10-day global period — follow-up visits within 10 days of the procedure are included in the reimbursement. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 1.65, this code ranks in the 10th percentile among Surgery codes — 4.8x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42104?
CPT 42104 (Excision lesion mouth roof) is a Surgery code. Surgical excision and removal of a small lesion from the palate with closure of the defect. Appropriate for lesions requiring tissue diagnosis and removal.
What is the wRVU value for CPT 42104?
The work RVU for CPT 42104 is 1.65. This code is primarily used by Oral Surgery, Dentistry. It has a 10-day global period.
When is CPT 42104 used?
Surgical procedure for benign or malignant lesions of the palate including papillomas, cysts, ulcers, or suspicious lesions requiring excision and histopathology.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.