CPT code 42509: Parotid duct diversion, bilateral2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $795.60 for 42509 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 42509 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 42509 covers

In bilateral parotid duct diversion, the surgeon reroutes the openings of both parotid ducts so saliva drains farther back in the mouth. Otolaryngologists and oral and maxillofacial surgeons may perform this operation for severe, persistent drooling, including in patients with neurologic conditions that impair saliva control. The service is performed in an operative setting and is distinct from repairing a damaged duct or injecting contrast to image the salivary system.

Report 42509 for the bilateral diversion service; the code is priced as bilateral, so modifier 50 does not increase payment. The operative report should establish that both parotid ducts were diverted and describe the work performed. The code has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment requires documented medical necessity; 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 Washington, DC area compares for 42509

Across 109 of 109 payment localities, the facility rate for 42509 runs from $652.27 in Arkansas to $903.49 in Alaska. Washington, DC area pays $795.60. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

42509 rates by state

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

See 42509 in every payment locality

How the 42509 rate is calculated

Each of 42509’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 42509

42509 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 42509

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

How 42509 has changed in Washington, DC area

Price 42509 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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