CPT 42281
Insertion palate prosthesis
CPT 42281 at a glance
- Code
- 42281
- Code type
- CPT/HCPCS
- Short descriptor
- Insertion palate prosthesis
- 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 42281?
CPT 42281 is a CPT/HCPCS procedure code. Its official CMS short descriptor is "Insertion palate prosthesis". In the ASC context it is grouped under ASC Surgical.
Is CPT 42281 payable in an ambulatory surgery center (ASC)?
CPT 42281 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 42281 typically performed?
Ambulatory surgery center (POS 24) or hospital outpatient department (POS 22).
Which specialties use CPT 42281?
CPT 42281 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.