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    OpenPayerBilling CodesExcision and Destruction Procedures on the Pharynx, Adenoids, and TonsilsCPT cpt-42809-pharynx-foreign-body-removal
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    CPT 42809: Removal of Foreign Body from Pharynx

    Medicare pays $222 on average nationally for this procedure.

    CPT code 42809 describes removal of a foreign body from the pharynx and represents an operative procedure performed by a clinician to extract an impacted or lodged object from the throat; the service is an procedural foreign body extraction typically performed in an operating room or procedure suite under direct visualization or endoscopic guidance and is coded when the provider physically removes the foreign material from the pharyngeal tissues.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Clinical & Coding Specifications

    Clinical Context

    A 6-year-old child presents to the emergency department after choking on a small toy piece. The patient has persistent gagging, drooling, and difficulty swallowing but maintains oxygenation and a patent airway. The emergency physician evaluates the airway and orders visualization with a flexible or rigid laryngoscope. The otolaryngologist is consulted and obtains informed consent from the caregiver for removal of a foreign body from the pharynx. Under appropriate topical anesthesia and, if needed, moderate sedation or general anesthesia, the provider inspects the oropharynx and hypopharynx, locates the foreign object, and removes it using forceps or suction. Hemostasis is confirmed, and the patient is observed for airway edema, aspiration risk, or need for further intervention. The typical site of service is the emergency department or ambulatory surgical center when the procedure requires anesthesia; minor removals may occur in an urgent care or clinic setting. Documentation includes the object removed, technique, anesthesia or sedation used, complications, and pre- and post-procedure airway status.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    42809Removal of foreign body from pharynxPrimary procedure for extraction of an object lodged in the pharynx
    Data not available in the input.Data not available in the input.Data not available in the input.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    P4Modifier P4 indicates the patient is ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life. It is assigned by the anesthesia provider and must be supported…- When to apply: Use modifier P4 only on anesthesia CPT codes (00100–01999) to indicate ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life (examples:…
    47Modifier -47 (“Anesthesia by Surgeon”) is appended to a surgical or procedural CPT code when the surgeon personally provides regional or general anesthesia for the procedure. Use of -47 indicates the…- Use modifier -47 when the surgeon personally provides regional or general anesthesia during the surgical procedure (i.e., the surgeon administers the anesthesia in addition to performing the…
    74Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    163WM0705X
    106E00000X
    2278S1500X
    227900000X
    246QM0706X
    2278P1004X
    2472D0500X
    372600000X

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-42800-OROPHARYNGEAL-BIOPSY

    CPT 42800: Biopsy, Oropharynx

    CPT-42804-NASOPHARYNGEAL-LESION-BIOPSY

    CPT 42804: Biopsy of Visible Nasopharyngeal Lesion

    CPT-42806-NASOPHARYNGEAL-BIOPSY-UNKNOWN-PRIMARY-LESION

    CPT 42806: Biopsy of Nasopharyngeal Lesion, Unknown Primary

    CPT-42808-PHARYNGEAL-LESION-DESTRUCTION-LASER-CRYOSURGERY

    CPT 42808: Pharynx Lesion Destruction (Laser, Cryosurgery, Electrocautery)

    CPT-42810-BRACHIAL-CLEFT-CYST-EXCISION

    CPT 42810: Excision of Brachial Cleft Cyst, Lateral Neck

    CPT-42815-BRACHIAL-CLEFT-CYST-EXCISION

    CPT 42815: Excision of Brachial Cleft Cyst, Lateral Neck

    CPT-42820-TONSILLECTOMY-AND-ADENOIDECTOMY-YOUNGER-THAN-12

    CPT 42820: Tonsillectomy and Adenoidectomy, Patient Younger Than 12 Years

    CPT-42821-TONSILLECTOMY-ADENOIDECTOMY-AGE-12-PLUS

    CPT 42821: Tonsillectomy with Adenoidectomy, Age 12 or Older

    CPT-42825-PEDIATRIC-TONSILLECTOMY-UNDER-12

    CPT 42825: Tonsillectomy in Patients Under 12 Years

    CPT-42826-TONSILLECTOMY-AGE-12-AND-OLDER

    CPT 42826: Tonsillectomy for Patients Age 12 and Older

    Showing 1–10 of 22

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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