CPT code 42505: Salivary duct repair, secondary, complicated2026 Medicare rate & RVUs in Tennessee

In Tennessee, Medicare pays $529.45 for 42505 in the office and $380.38 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 42505 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 42505 covers

This service involves complex reconstruction of a salivary duct after an earlier procedure, injury, or disease has left the duct damaged or scarred. The surgeon restores duct continuity or function through a secondary repair; the work may involve reconstructing or repositioning the duct. Otolaryngologists and oral and maxillofacial surgeons typically perform it in an operating room, including for parotid or other major salivary duct problems.

Choose this code when the operative work is a complicated secondary repair, rather than a simple primary duct procedure. Document the reason for secondary reconstruction, the condition of the duct, and the repair performed. The day-before preoperative visit and related postoperative care through day 90 are included in the global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Medicare does not pay an assistant at surgery for this service under the statutory restriction; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Tennessee compares for 42505

Across 109 of 109 payment localities, the office rate for 42505 runs from $511.87 in Arkansas to $732.40 in San Benito County, CA. Tennessee pays $529.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42505 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 42505 in every payment locality

How the 42505 rate is calculated

Each of 42505’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 42505

42505 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 42505

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 42505 has changed in Tennessee

Price 42505 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

• Adams
• Adamsville
• Alamo
• Alcoa
• Alexandria
• Algood
• Allardt
• Altamont

Browse all communities in Tennessee

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates