CPT code 42660: Salivary duct dilation, complicated procedure2026 Medicare rate & RVUs
Report this service for a complicated dilation of a narrowed salivary duct, such as the parotid or submandibular duct, to restore drainage.
Medicare pays $102.21 for 42660 nationally in the office and $70.14 in a hospital or facility. Local office rates run $91.14–$130.34.
Medicare rate · 42660
Salivary duct dilation, complicated procedure
- Work RVUs
- 1.1
- Total RVUs
- 3.06
- Global days
- 000
National rate · 2026
$102.21
Office setting, before claim adjustments.
See every locality for 42660 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 42660 covers
An otolaryngologist or oral and maxillofacial surgeon may dilate a narrowed salivary duct to improve saliva flow. The procedure may address stenosis in the parotid duct or a submandibular duct, often associated with obstructive symptoms such as recurrent gland swelling around meals. Code 42660 distinguishes a complicated dilation from a less complex duct dilation; the operative record should make the nature of the added complexity clear.
Select the code based on the procedure performed and its documented complexity, not symptoms alone. Record the duct treated, the narrowing or obstruction, the technique, and the work supporting the complicated level. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant is paid only when medical necessity is documented; 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.
Where 42660 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$91.14 to $130.34
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $92.37 | $64.32 |
| Alaska | $122.09 | $87.94 |
| Arizona | $99.57 | $68.50 |
| Arkansas | $91.14 | $63.59 |
| Atlanta, GA | $104.35 | $71.78 |
| Austin, TX | $105.16 | $71.23 |
| Bakersfield, CA | $106.59 | $71.44 |
| Baltimore area, MD | $108.45 | $74.04 |
| Beaumont, TX | $96.42 | $67.24 |
| Brazoria, TX | $100.78 | $69.01 |
| Chicago, IL | $109.69 | $77.46 |
| Chico, CA | $106.12 | $70.98 |
| Colorado | $105.33 | $71.21 |
| Connecticut | $108.69 | $74.16 |
| Dallas, TX | $101.54 | $69.60 |
| Delaware | $101.13 | $69.45 |
| Detroit, MI | $103.77 | $72.83 |
| East St. Louis, IL | $102.82 | $73.32 |
| El Centro, CA | $106.15 | $71.01 |
| Fort Lauderdale, FL | $107.31 | $74.82 |
| Fort Worth, TX | $101.01 | $69.39 |
| Fresno, CA | $106.12 | $70.98 |
| Galveston, TX | $101.16 | $69.32 |
| Hanford, CA | $106.12 | $70.98 |
| Hawaii, Guam, HI | $108.19 | $71.74 |
| Houston, TX | $104.09 | $72.25 |
| Idaho | $94.58 | $65.08 |
| Indiana | $95.07 | $65.35 |
| Iowa | $93.87 | $64.53 |
| Kansas | $93.78 | $64.80 |
| Kentucky | $95.08 | $66.57 |
| King County, WA | $116.71 | $77.37 |
| Los Angeles, CA | $112.92 | $74.99 |
| Madera, CA | $106.12 | $70.98 |
| Manhattan, NY | $117.43 | $80.17 |
| Marin County, CA | $127.46 | $82.24 |
| Merced, CA | $106.12 | $70.98 |
| Metropolitan Boston, MA | $114.79 | $76.50 |
| Metropolitan Kansas City, MO | $98.42 | $68.31 |
| Metropolitan Philadelphia, PA | $106.36 | $72.98 |
| Metropolitan St. Louis, MO | $99.33 | $68.81 |
| Miami, FL | $112.84 | $79.46 |
| Minnesota | $100.19 | $67.19 |
| Mississippi | $92.46 | $64.85 |
| Modesto, CA | $106.12 | $70.98 |
| Montana | $102.20 | $70.13 |
| Napa, CA | $121.01 | $78.75 |
| Nebraska | $94.25 | $64.66 |
| Nevada | $101.37 | $69.28 |
| New Hampshire | $104.00 | $70.62 |
| New Mexico | $98.29 | $68.89 |
| New Orleans, LA | $99.39 | $69.21 |
| North Carolina | $96.25 | $66.33 |
| North Dakota | $99.03 | $66.97 |
| Northern New Jersey | $114.50 | $77.31 |
| NYC suburbs and Long Island, NY | $120.50 | $82.38 |
| Ohio | $97.02 | $67.74 |
| Oklahoma | $94.58 | $65.95 |
| Oxnard, CA | $112.16 | $74.26 |
| Portland, OR | $108.10 | $72.48 |
| Poughkeepsie and northern NYC suburbs, NY | $110.69 | $75.58 |
| Puerto Rico | $102.79 | $70.37 |
| Queens, NY | $117.86 | $79.96 |
| Redding, CA | $106.12 | $70.98 |
| Rest of California | $106.12 | $70.98 |
| Rest of Florida | $102.25 | $71.60 |
| Rest of Georgia | $96.74 | $68.14 |
| Rest of Illinois | $99.98 | $70.71 |
| Rest of Louisiana | $95.07 | $66.69 |
| Rest of Maine | $95.38 | $65.88 |
| Rest of Maryland | $102.86 | $70.41 |
| Rest of Massachusetts | $104.90 | $71.13 |
| Rest of Michigan | $97.67 | $68.39 |
| Rest of Missouri | $93.77 | $66.13 |
| Rest of New Jersey | $109.73 | $74.71 |
| Rest of New York | $97.61 | $67.15 |
| Rest of Oregon | $100.38 | $68.44 |
| Rest of Pennsylvania | $96.98 | $67.55 |
| Rest of Texas | $98.62 | $68.19 |
| Rest of Washington | $104.59 | $70.83 |
| Rhode Island | $104.31 | $71.19 |
| Riverside, CA | $107.85 | $72.71 |
| Sacramento, CA | $110.85 | $73.56 |
| Salinas, CA | $110.43 | $73.26 |
| San Benito County, CA | $130.34 | $84.10 |
| San Diego, CA | $112.65 | $74.30 |
| San Francisco, CA | $127.27 | $82.06 |
| San Luis Obispo, CA | $108.71 | $72.19 |
| Santa Clara County, CA | $129.60 | $83.36 |
| Santa Cruz, CA | $113.42 | $74.47 |
| Santa Maria, CA | $110.74 | $73.35 |
| Santa Rosa, CA | $114.54 | $75.16 |
| South Carolina | $96.84 | $67.21 |
| South Dakota | $98.66 | $66.59 |
| Southern Maine, ME | $99.69 | $67.92 |
| Stockton, CA | $106.12 | $70.98 |
| Suburban Chicago, IL | $108.21 | $75.28 |
| Tennessee | $94.26 | $65.11 |
| Utah | $98.05 | $67.91 |
| Vallejo, CA | $120.75 | $78.49 |
| Vermont | $98.97 | $67.22 |
| Virgin Islands, VI | $102.79 | $70.37 |
| Virginia | $99.61 | $68.09 |
| Visalia, CA | $106.12 | $70.98 |
| Washington, DC area | $115.50 | $77.72 |
| West Virginia | $96.63 | $68.77 |
| Wisconsin | $95.98 | $65.27 |
| Wyoming | $100.82 | $68.75 |
| Yuba City, CA | $106.12 | $70.98 |
42660 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$91.14
$122.09
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $122.09 | 1 |
| AL | $92.37 | 1 |
| AR | $91.14 | 1 |
| AZ | $99.57 | 1 |
| CA | $106.12–$130.34 | 29 |
| CO | $105.33 | 1 |
| CT | $108.69 | 1 |
| DC | $115.50 | 1 |
| DE | $101.13 | 1 |
| FL | $102.25–$112.84 | 3 |
| GA | $96.74–$104.35 | 2 |
| GU | $108.19 | 1 |
| HI | $108.19 | 1 |
| IA | $93.87 | 1 |
| ID | $94.58 | 1 |
| IL | $99.98–$109.69 | 4 |
| IN | $95.07 | 1 |
| KS | $93.78 | 1 |
| KY | $95.08 | 1 |
| LA | $95.07–$99.39 | 2 |
| MA | $104.90–$114.79 | 2 |
| MD | $102.86–$115.50 | 3 |
| ME | $95.38–$99.69 | 2 |
| MI | $97.67–$103.77 | 2 |
| MN | $100.19 | 1 |
| MO | $93.77–$99.33 | 3 |
| MS | $92.46 | 1 |
| MT | $102.20 | 1 |
| NC | $96.25 | 1 |
| ND | $99.03 | 1 |
| NE | $94.25 | 1 |
| NH | $104.00 | 1 |
| NJ | $109.73–$114.50 | 2 |
| NM | $98.29 | 1 |
| NV | $101.37 | 1 |
| NY | $97.61–$120.50 | 5 |
| OH | $97.02 | 1 |
| OK | $94.58 | 1 |
| OR | $100.38–$108.10 | 2 |
| PA | $96.98–$106.36 | 2 |
| PR | $102.79 | 1 |
| RI | $104.31 | 1 |
| SC | $96.84 | 1 |
| SD | $98.66 | 1 |
| TN | $94.26 | 1 |
| TX | $96.42–$105.16 | 8 |
| UT | $98.05 | 1 |
| VA | $99.61–$115.50 | 2 |
| VI | $102.79 | 1 |
| VT | $98.97 | 1 |
| WA | $104.59–$116.71 | 2 |
| WI | $95.98 | 1 |
| WV | $96.63 | 1 |
| WY | $100.82 | 1 |
How the 42660 rate is calculated
Each of 42660’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.
How the rate is built · 42660
RVUs × geographic indexes × conversion factor
Work1.10
1.10 RVUs× 1.000 GPCI
Practice expense1.80
1.80 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
3.0600
Conversion factor
$33.4009
Medicare rate
$102.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42660
The CMS indicators that decide how 42660 is paid alongside other services.
CMS payment indicators · 42660
Salivary duct dilation, complicated procedure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42660 without 51 · national office
$102.21
Salivary duct dilation, complicated procedure
42660-51 · Second procedure: 50%
$51.11
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
42660 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 42650Salivary duct dilationPercutaneous approach
- Use 42650 for the less complex dilation level. Use 42660 when the operative details support a complicated dilation.
- 42665Salivary duct surgeryDuct interruption
- 42665 describes ligation of a salivary duct, which closes the duct; 42660 dilates a narrowed duct to improve its patency.
- 42699Salivary procedureUnlisted procedure
- Use 42660 when the service is a complicated salivary duct dilation. Reserve 42699 for a salivary duct procedure that lacks a specific listed code.
42660 billing questions
How is 42660 distinguished from 42650?
42660 is for a complicated dilation; 42650 represents the less complex level. Document the procedural details that support the complicated level rather than relying on the diagnosis alone.
Can modifier 50 be reported for bilateral duct dilation?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
How are other procedures performed in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
What documentation supports this code?
Document the salivary duct treated, the narrowing or obstruction, the dilation technique, and the details establishing that the procedure was complicated rather than less complex.
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
Show the CMS file lines behind this rate
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