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See a sample rate comparisonCPT 42299 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery On Uvula Or Palate, Surgery Performed On The Uvula Or The Roof Of The Mouth (Palate).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | UB 51 - Multiple procedures AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 42299 |
| Medicaid Fee Schedule | View Medicaid rates for 42299 |
National average reimbursement for CPT 42299 by major payers:
$1,186.41
$202.39
$703.00
$1,047.45
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CPT 42299
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes South Surgery Center LLC
$6,623.00Published ratePalmetto Surgery Center LLC
Palmetto Surgery Center, LLC
$544.00Published rateSurgery Center At River Road, LLC, Aesthetic Surgery At Hacienda Del Sol
Surgery Center At River Road, LLC
$230.00Published ratePalmetto Endoscopy Center LLC
$100.00Published rateChesapeake Ambulatory Surgery Center
$36.00Published rate
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See a sample payer proposalCPT 42299 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 42299 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 42299 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 42280-CPT | Moderate | Maxillary Impression For Palatal Prosthe |
| 42281-CPT | Moderate | Insert Prosthesis Palate Pin Type |
| 42299-CPT | High | Surgery On Uvula Or Palate, Surgery Performed On The Uvula Or The Roof Of The Mouth (Palate). |
| 42340-CPT | Moderate | Sialolithotomy Parotid Extra, Sialolithotomy Parotid Extraoral Or Complicated Intraoral Sialolithotomy Parotid Extraoral Or Complicated Intraoral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 42299. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 42299 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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