42225 Reconstruct cleft palate
Also known as: cleft palate repair, soft palate reconstruction
Surgical reconstruction of a cleft palate with restoration of soft palate continuity and velopharyngeal closure mechanisms.
In Plain Language
repair of split palate
Clinical Context
Surgical repair emphasizing soft palate reconstruction and velopharyngeal competence for normal speech and swallowing function.
RVU Breakdown
| Work RVU | 9.53 |
| Total RVU | 9.53 |
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 9.53, this code ranks in the 57th percentile among Surgery codes — 1.2x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42225?
CPT 42225 (Reconstruct cleft palate) is a Surgery code. Surgical reconstruction of a cleft palate with restoration of soft palate continuity and velopharyngeal closure mechanisms.
What is the wRVU value for CPT 42225?
The work RVU for CPT 42225 is 9.53. This code is primarily used by Oral Surgery, Plastic Surgery. It has a 90-day global period.
When is CPT 42225 used?
Surgical repair emphasizing soft palate reconstruction and velopharyngeal competence for normal speech and swallowing function.
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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.