42215 Reconstruct cleft palate
Also known as: cleft palate repair, palate revision
Surgical reconstruction of a cleft palate, often for secondary revision, correction of residual defects, or repair of palatal problems from previous surgery.
In Plain Language
fix for cleft palate
Clinical Context
Revision or secondary repair of cleft palate for residual velopharyngeal insufficiency, fistula closure, or anatomic refinement.
RVU Breakdown
| Work RVU | 8.77 |
| Total RVU | 8.77 |
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 8.77, this code ranks in the 53rd percentile among Surgery codes — 1.1x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42215?
CPT 42215 (Reconstruct cleft palate) is a Surgery code. Surgical reconstruction of a cleft palate, often for secondary revision, correction of residual defects, or repair of palatal problems from previous surgery.
What is the wRVU value for CPT 42215?
The work RVU for CPT 42215 is 8.77. This code is primarily used by Oral Surgery, Plastic Surgery. It has a 90-day global period.
When is CPT 42215 used?
Revision or secondary repair of cleft palate for residual velopharyngeal insufficiency, fistula closure, or anatomic refinement.
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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.