CPT 42205
Reconstruct cleft palate
CPT 42205 at a glance
- Code
- 42205
- Code type
- CPT/HCPCS
- Short descriptor
- Reconstruct cleft palate
- Category
- ASC Surgical
- ASC eligibility
- ASC-eligible (surgical)
- Typical setting
- Ambulatory surgery center (POS 24) or hospital outpatient department (POS 22).
- Medicare ASC rate
- $1,480.50 national · 2026Q2
What is CPT code 42205?
CPT 42205 is a CPT/HCPCS procedure code. Its official short descriptor is "Reconstruct cleft palate". In the ASC context it is grouped under ASC Surgical.
Is CPT 42205 eligible in an ambulatory surgery center (ASC)?
CPT 42205 can be performed in a certified ambulatory surgery center.
Where is CPT 42205 typically performed?
Ambulatory surgery center (POS 24) or hospital outpatient department (POS 22).
What is the Medicare ASC payment rate for CPT 42205?
The national Medicare ASC payment rate for CPT 42205 is $1,480.50 (CMS ASC Payment System, 2026Q2). This is the national, unadjusted amount published by CMS; the amount an individual ambulatory surgery center is paid is adjusted for local wage index and may differ. It reflects Medicare's facility payment only and does not include the surgeon's professional fee.
Which specialties use CPT 42205?
CPT 42205 is most associated with General Surgery.
Reference information about ASC eligibility and typical procedure setting. Codes, descriptors, and ASC-eligibility status change over time. This is a coding reference, not billing, coding, or legal advice. Always verify against current guidance and individual payer policy before scheduling or billing. CPT is a registered trademark of the American Medical Association.