42281 Insertion palate prosthesis
Also known as: palate prosthesis insertion, denture insertion
Insertion of a palatal prosthesis or denture device to replace or support palatal tissues in prosthetic rehabilitation or functional restoration.
In Plain Language
placing artificial palate device
Clinical Context
Prosthodontic insertion of palatal dentures, partial prostheses, or obturators for cleft palate, surgical defects, or acquired palatal deficiency.
RVU Breakdown
| Work RVU | 1.93 |
| Total RVU | 1.93 |
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 10-day global period — follow-up visits within 10 days of the procedure are included in the reimbursement. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 1.93, this code ranks in the 13th percentile among Surgery codes — 4.1x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42281?
CPT 42281 (Insertion palate prosthesis) is a Surgery code. Insertion of a palatal prosthesis or denture device to replace or support palatal tissues in prosthetic rehabilitation or functional restoration.
What is the wRVU value for CPT 42281?
The work RVU for CPT 42281 is 1.93. This code is primarily used by Prosthodontics, Dentistry. It has a 10-day global period.
When is CPT 42281 used?
Prosthodontic insertion of palatal dentures, partial prostheses, or obturators for cleft palate, surgical defects, or acquired palatal deficiency.
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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.