42210 Reconstruct cleft palate
Also known as: cleft palate repair, complex palate reconstruction
Surgical reconstruction of a cleft palate with significant anatomic involvement or complexity requiring extensive surgical techniques and reconstruction.
In Plain Language
surgery to fix large cleft in roof of mouth
Clinical Context
Definitive surgical repair of complex cleft palate with extensive defects, multiple tissue layers involved, or requiring vomer flap techniques.
RVU Breakdown
| Work RVU | 14.65 |
| Total RVU | 14.65 |
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 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 14.65, this code ranks in the 72nd percentile among Surgery codes — 1.8x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42210?
CPT 42210 (Reconstruct cleft palate) is a Surgery code. Surgical reconstruction of a cleft palate with significant anatomic involvement or complexity requiring extensive surgical techniques and reconstruction.
What is the wRVU value for CPT 42210?
The work RVU for CPT 42210 is 14.65. This code is primarily used by Oral Surgery, Plastic Surgery, Pediatric Surgery. It has a 90-day global period.
When is CPT 42210 used?
Definitive surgical repair of complex cleft palate with extensive defects, multiple tissue layers involved, or requiring vomer flap techniques.
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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.