CPT 42260
Repair nose to lip fistula
CPT 42260 at a glance
- Code
- 42260
- Code type
- CPT/HCPCS
- Short descriptor
- Repair nose to lip fistula
- Category
- ASC Surgical
- ASC payment status
- Payable in an ASC (surgical)
- CMS addendum
- AA (Surgical)
- Typical setting
- Ambulatory surgery center (POS 24) or hospital outpatient department (POS 22).
What is CPT code 42260?
CPT 42260 is a CPT/HCPCS procedure code. Its official CMS short descriptor is "Repair nose to lip fistula". In the ASC context it is grouped under ASC Surgical.
Is CPT 42260 payable in an ambulatory surgery center (ASC)?
CPT 42260 appears on Medicare's ASC Covered Procedures List (CMS Addendum AA), so Medicare reimburses it when the surgery is performed in a certified ambulatory surgery center.
Where is CPT 42260 typically performed?
Ambulatory surgery center (POS 24) or hospital outpatient department (POS 22).
Which specialties use CPT 42260?
CPT 42260 is most associated with General Surgery.
Reference information compiled from the CMS April 2026 ASC payment addenda (AA, BB, EE). Codes, descriptors, and ASC payment status change with each CMS update. This is a coding reference, not billing, coding, or legal advice. Always verify against the current CMS addenda and individual payer policy before billing. CPT is a registered trademark of the American Medical Association.