42205 Reconstruct cleft palate
Also known as: cleft palate repair, extended palate repair
Surgical reconstruction of a cleft palate with additional complexity or extent compared to standard repair, such as wide clefts or secondary repair.
In Plain Language
surgery to fix split palate
Clinical Context
Surgical repair of cleft palate with increased complexity from wide defects, secondary procedures, or additional anatomic involvement.
RVU Breakdown
| Work RVU | 13.32 |
| Total RVU | 13.32 |
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 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 13.32, this code ranks in the 68th percentile among Surgery codes — 1.7x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42205?
CPT 42205 (Reconstruct cleft palate) is a Surgery code. Surgical reconstruction of a cleft palate with additional complexity or extent compared to standard repair, such as wide clefts or secondary repair.
What is the wRVU value for CPT 42205?
The work RVU for CPT 42205 is 13.32. This code is primarily used by Oral Surgery, Plastic Surgery. It has a 90-day global period.
When is CPT 42205 used?
Surgical repair of cleft palate with increased complexity from wide defects, secondary procedures, or additional anatomic involvement.
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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.