2025 CPT code 42227

Lengthening of palate, with island flap

Modifiers may apply, for instance, if the procedure is significantly more complex than usual (modifier 22), or performed by multiple surgeons (modifiers 62, 80, 81, 82) under specific circumstances.

Medical necessity must be justified by documentation demonstrating functional impairment due to the short palate, such as nasal speech, difficulty swallowing, or velopharyngeal insufficiency impacting speech or swallowing.

The surgeon makes incisions, harvests the palatal island flap, rotates it, and ensures the vascular pedicle is not compromised.The surgeon also manages the donor site for secondary intention healing.

IMPORTANT If a pharyngeal flap is used to lengthen the soft palate, see 42226. For cleft palate palatoplasty, see 42200 to 42225.

In simple words: This procedure lengthens the soft palate (the back part of the roof of your mouth) using a small piece of tissue (a flap) from the roof of the mouth. This flap remains attached at one end and is moved to its new position to lengthen the palate.

The provider lengthens the soft palate by creating island flaps in the mucosal tissue and suturing them in new positions.The provider makes incisions at the junction of the hard and soft palate. A palatal island flap, composed of nutrient vessels, is harvested and rotated 180 degrees to widen the palate without compromising the vascular pedicle. The donor site heals by secondary intention.

Example 1: A patient with a short soft palate causing nasal speech undergoes palate lengthening with an island flap to improve speech clarity., A patient with velopharyngeal insufficiency, where the soft palate doesn't close tightly against the back of the throat during speech, has this procedure to improve closure and reduce nasality., Following a palatal injury or previous surgery resulting in a shortened palate, a patient requires an island flap for palate lengthening and functional reconstruction.

Documentation should include the diagnosis necessitating palate lengthening (e.g., velopharyngeal insufficiency, short palate), operative details (including flap dimensions and location), and pre- and postoperative speech assessments.

  • Revenue Code: P1G - MAJOR PROCEDURE - OTHER
  • Specialties:Plastic Surgery, Oral and Maxillofacial Surgery, Otolaryngology
  • Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department, Inpatient Hospital (if medically necessary)
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