Summary & Overview
CPT 42140: Uvula Removal (Uvulopalatopharyngoplasty)
CPT code 42140 denotes surgical removal of the uvula, a procedure commonly used to reduce snoring and address select upper airway issues. Nationally, this code is relevant to otolaryngology practice patterns, surgical service utilization, and payer coverage policies affecting access to procedural care for sleep-disordered breathing. It also has implications for facility use when performed in ambulatory surgery centers or hospital operating rooms.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and prior authorization requirements among these payers influence where and when the procedure is performed and billed.
Readers will find a concise overview of the clinical context for 42140, the typical sites of service, and the primary payers addressed in payer policy reviews. The publication also summarizes available benchmarks and policy considerations, clarifies common billing and service-line contexts, and identifies gaps where input data is not available. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 42140 describes a surgical procedure to remove the uvula at the back of the mouth. The procedure is typically performed to address snoring and related upper airway symptoms when removal of the uvula is clinically indicated.
Service type: Otolaryngology / Head and Neck Surgical Procedure
Typical site of service: Ambulatory surgery center or hospital operating room, often performed under local or general anesthesia depending on clinical circumstances.
Clinical & Coding Specifications
Clinical Context
A 42-year-old male with chronic primary snoring and persistent uvulopalatopharyngeal redundancy presents to an otolaryngology clinic after conservative measures (weight loss, positional therapy, oral appliance) produced inadequate symptom control. Evaluation includes history, physical exam with flexible nasopharyngoscopy, and sleep-focused assessment. The patient reports disruptive snoring affecting bed partner and daytime fatigue without high-risk obstructive sleep apnea features. The clinician discusses surgical options and elects to perform a simple uvulectomy (removal of the uvula) to reduce posterior airway turbulence.
The clinical workflow: preoperative assessment and informed consent are completed in clinic. Relevant imaging and sleep study results are reviewed if available. The procedure is scheduled in an ambulatory surgery center or hospital outpatient department under local anesthesia with monitored sedation or general anesthesia depending on patient factors. The surgeon performs 42140 (uvulectomy), achieves hemostasis, and documents the technique and estimated blood loss. Postoperative recovery includes observation for airway compromise and pain control, discharge with wound care instructions, and a follow-up visit to assess symptom improvement and healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |