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CPT code 42660: Salivary duct dilation, complicated procedure2026 Medicare rate & RVUs in Los Angeles, CA

Report this service for a complicated dilation of a narrowed salivary duct, such as the parotid or submandibular duct, to restore drainage.

CMS RVU26DEffective Oct 1, 2026One payment locality332 Medicare services in 2024

In Los Angeles, CA, Medicare pays $112.92 for 42660 in the office and $74.99 when it’s performed in a hospital or facility.

$112.92Office (non-facility)
$74.99Hospital or facility
+10.5%vs the national office rate ($102.21)

Check a contract rate as a % of Medicare · 42660 nationwide

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

We’ll open 42660 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 42660 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Los Angeles, CA compares for 42660

Across 109 of 109 payment localities, the office rate for 42660 runs from $91.14 in Arkansas to $130.34 in San Benito County, CA. Los Angeles, CA pays $112.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

42660 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$112.92
  2. Bakersfield, CA · California$106.59−$6.33
  3. Chico, CA · California$106.12−$6.80
  4. El Centro, CA · California$106.15−$6.77
  5. Fresno, CA · California$106.12−$6.80
  6. Hanford, CA · California$106.12−$6.80
  7. Madera, CA · California$106.12−$6.80

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

42660 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$106.12$70.98
Modesto, CACalifornia$106.12$70.98
Napa, CACalifornia$121.01$78.75
Oxnard, CACalifornia$112.16$74.26
Redding, CACalifornia$106.12$70.98
Rest of CaliforniaCalifornia$106.12$70.98
Riverside, CACalifornia$107.85$72.71
Sacramento, CACalifornia$110.85$73.56

42660 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
42660 office rate range by state
State / territoryOffice rate rangeLocalities
AK$122.091
AL$92.371
AR$91.141
AZ$99.571
CA$106.12–$130.3429
CO$105.331
CT$108.691
DC$115.501
DE$101.131
FL$102.25–$112.843
GA$96.74–$104.352
GU$108.191
HI$108.191
IA$93.871
ID$94.581
IL$99.98–$109.694
IN$95.071
KS$93.781
KY$95.081
LA$95.07–$99.392
MA$104.90–$114.792
MD$102.86–$115.503
ME$95.38–$99.692
MI$97.67–$103.772
MN$100.191
MO$93.77–$99.333
MS$92.461
MT$102.201
NC$96.251
ND$99.031
NE$94.251
NH$104.001
NJ$109.73–$114.502
NM$98.291
NV$101.371
NY$97.61–$120.505
OH$97.021
OK$94.581
OR$100.38–$108.102
PA$96.98–$106.362
PR$102.791
RI$104.311
SC$96.841
SD$98.661
TN$94.261
TX$96.42–$105.168
UT$98.051
VA$99.61–$115.502
VI$102.791
VT$98.971
WA$104.59–$116.712
WI$95.981
WV$96.631
WY$100.821

See 42660 in every payment locality

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

Office or facility?

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.

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,056

Code
42660
Physician work
1.10
Practice expense
1.80
Malpractice
0.16

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 42660 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work1.10× 1.0411.1451
Practice expense1.80× 1.1832.1294
Malpractice0.16× 0.6640.1062
Total RVUs3.3807
Conversion factor× 33.4009

Office rate, Los Angeles, CA$112.92

Office: (1.1 × 1.041 + 1.8 × 1.183 + 0.16 × 0.664) × $33.4009 = $112.92

Facility: (1.1 × 1.041 + 0.84 × 1.183 + 0.16 × 0.664) × $33.4009 = $74.99

Open 42660 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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%).

When to use modifier 51

Codes related to 42660

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

Codes related to 42660
CodeHow it relatesOffice range, Los Angeles, CA
Same family
42650Salivary duct dilation, percutaneous approachThe less complex salivary duct dilation level.$85.42
Used instead
42699Salivary procedure, unlisted procedureFor a salivary duct procedure without a specific listed code; complexity alone does not make the service unlisted.No office rate
42665Salivary duct surgery, duct interruptionDuct ligation is a different intervention when the operative goal is to close rather than dilate the duct.$417.10

How 42660 has changed in Los Angeles, CA

42660 · Office / nonfacility

$112.92

Effective 2026-10-01

The base rate is $5.61 higher than on 2025-10-01, moving from $107.31 to $112.92 (5.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $107.31changed to$112.92

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.13 changed to 1.10
    • Practice expense RVU 1.70 changed to 1.80
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $123.69changed to$107.31

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.97 changed to 1.70
    • Malpractice RVU 0.27 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $121.68changed to$123.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $131.15changed to$121.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.08 changed to 1.97
    • Malpractice RVU 0.31 changed to 0.27
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $132.08changed to$131.15

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.06 changed to 2.08
    • Malpractice RVU 0.28 changed to 0.31
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $135.37changed to$132.08

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.12 changed to 2.06
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $139.25changed to$135.37

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.09 changed to 2.12
    • Malpractice RVU 0.30 changed to 0.27
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $142.05changed to$139.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.15 changed to 2.09
    • Malpractice RVU 0.33 changed to 0.30
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $146.38changed to$142.05

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.25 changed to 2.15
    • Malpractice RVU 0.34 changed to 0.33

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $145.79changed to$146.38

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.23 changed to 2.25
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $146.94changed to$145.79

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.25 changed to 2.23
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $145.81changed to$146.94

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.21 changed to 2.25

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $145.08changed to$145.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $139.54changed to$145.08

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.26 changed to 2.21
    • Malpractice RVU 0.13 changed to 0.34
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $140.65changed to$139.54

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.49 changed to 2.26
    • Malpractice RVU 0.14 changed to 0.13
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$140.65

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$112.92$74.99RVU26D
2026-07-01$112.92$74.99RVU26C
2026-04-01$112.92$74.99RVU26B
2026-01-01$112.92$74.99RVU26A
2025-10-01$107.31$84.14RVU25D
2025-07-01$107.31$84.14RVU25C
2025-04-01$107.31$84.14RVU25B
2025-01-01$107.31$84.14RVU25A
2024-10-01$123.69$93.09RVU24D
2024-07-01$123.69$93.09RVU24C
2024-04-01$123.69$93.09RVU24B
2024-03-09$123.69$93.09RVU24AR
2024-01-01$121.68$91.57RVU24A
2023-10-01$131.15$96.21RVU23D
2023-07-01$131.15$96.21RVU23C
2023-04-01$131.15$96.21RVU23B
2023-01-01$131.15$96.21RVU23A
2022-10-01$132.08$95.89RVU22D
2022-07-01$132.08$95.89RVU22C
2022-04-01$132.08$95.89RVU22B
2022-01-01$132.08$95.89RVU22A
2021-10-01$135.37$94.78RVU21D
2021-07-01$135.37$94.78RVU21C
2021-04-01$135.37$94.78RVU21B
2021-01-01$135.37$94.78RVU21A
2020-10-01$139.25$96.81RVU20D
2020-07-01$139.25$96.81RVU20C
2020-04-01$139.25$96.81RVU20B
2020-01-01$139.25$96.81RVU20A
2019-10-01$142.05$97.94RVU19D
2019-07-01$142.05$97.94RVU19C
2019-04-01$142.05$97.94RVU19B
2019-01-01$142.05$97.94RVU19A
2018-10-01$146.38$98.93RVU18D
2018-07-01$146.38$98.93RVU18C
2018-04-01$146.38$98.93RVU18B
2018-01-01$146.38$98.93RVU18AR1
2017-10-01$145.79$99.64RVU17D
2017-07-01$145.79$99.64RVU17C
2017-04-01$145.79$99.64RVU17B
2017-01-01$145.79$99.64RVU17A
2016-10-01$146.94$100.80RVU16D
2016-07-01$146.94$100.80RVU16C
2016-04-01$146.94$100.80RVU16B
2016-01-01$146.94$100.80RVU16A
2015-10-01$145.81$100.75RVU15D
2015-07-01$145.81$100.75RVU15C
2015-04-01$145.08$100.25RVU15B
2015-01-01$145.08$100.25RVU15A
2014-10-01$139.54$93.49RVU14D
2014-07-01$139.54$93.49RVU14C
2014-04-01$139.54$93.49RVU14B
2014-01-01$139.54$93.49RVU14A
2013-10-01$140.65$91.97RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 42660 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

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
RVUs for 42660PPRRVU2026_Oct_nonQPP.csv, line 5,056 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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