42220 Reconstruct cleft palate
Also known as: cleft palate repair, palate reconstruction
Surgical reconstruction of a cleft palate with specific attention to restoring normal anatomic relationships and function.
In Plain Language
repair of cleft palate
Clinical Context
Primary or secondary cleft palate reconstruction in pediatric or adult patients to restore anatomic form and functional swallowing and speech.
RVU Breakdown
| Work RVU | 6.98 |
| Total RVU | 6.98 |
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 6.98, this code ranks in the 45th percentile among Surgery codes — 1.1x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42220?
CPT 42220 (Reconstruct cleft palate) is a Surgery code. Surgical reconstruction of a cleft palate with specific attention to restoring normal anatomic relationships and function.
What is the wRVU value for CPT 42220?
The work RVU for CPT 42220 is 6.98. This code is primarily used by Oral Surgery, Plastic Surgery. It has a 90-day global period.
When is CPT 42220 used?
Primary or secondary cleft palate reconstruction in pediatric or adult patients to restore anatomic form and functional swallowing and speech.
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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.