42860 Excision of tonsil tags
Also known as: tonsil tag removal, residual tonsil excision
Excision (surgical removal) of tonsil tags (residual tonsil tissue) from the oropharynx via transoral approach.
In Plain Language
removal of extra tonsil tissue; tonsil remnant removal
Clinical Context
Performed for residual tonsillar tissue causing dysphagia, hypertrophy, or recurrent infection after previous incomplete tonsilectomy. May improve symptoms of swallowing or sensation.
RVU Breakdown
| Work RVU | 2.24 |
| Total RVU | 2.24 |
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 2.24, this code ranks in the 15th percentile among Surgery codes — 3.6x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 42860?
CPT 42860 (Excision of tonsil tags) is a Surgery code. Excision (surgical removal) of tonsil tags (residual tonsil tissue) from the oropharynx via transoral approach.
What is the wRVU value for CPT 42860?
The work RVU for CPT 42860 is 2.24. This code is primarily used by Otolaryngology. It has a 90-day global period.
When is CPT 42860 used?
Performed for residual tonsillar tissue causing dysphagia, hypertrophy, or recurrent infection after previous incomplete tonsilectomy. May improve symptoms of swallowing or sensation.
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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.