42826 Removal of tonsils
Also known as: pediatric tonsillectomy, child tonsil removal, tonsillectomy age 12 or older, adult tonsillectomy, tonsillectomy primary
Removal of tonsils only (bilateral tonsilectomy) via transoral approach in patient younger than 12 years.
In Plain Language
removal of both tonsils in children; throat gland surgery for kids
Clinical Context
Indicated for recurrent infections or obstructive sleep apnea in children. Performed with pediatric-specific techniques and anesthetic considerations.
RVU Breakdown
| Work RVU | 3.36 |
| Total RVU | 3.36 |
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 3.36, this code ranks in the 23rd percentile among Surgery codes — 2.4x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42826?
CPT 42826 (Removal of tonsils) is a Surgery code. Removal of tonsils only (bilateral tonsilectomy) via transoral approach in patient younger than 12 years.
What is the wRVU value for CPT 42826?
The work RVU for CPT 42826 is 3.36. This code is primarily used by Otolaryngology, Pediatric Surgery. It has a 90-day global period.
When is CPT 42826 used?
Indicated for recurrent infections or obstructive sleep apnea in children. Performed with pediatric-specific techniques and anesthetic considerations.
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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.