CPT code 42660: Salivary duct dilation, complicated procedure2026 Medicare rate & RVUs in Marin County, CA
Report this service for a complicated dilation of a narrowed salivary duct, such as the parotid or submandibular duct, to restore drainage.
In Marin County, CA, Medicare pays $127.46 for 42660 in the office and $82.24 when it’s performed in a hospital or facility.
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.
On this page 11 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.
How Marin County, 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. Marin County, CA pays $127.46. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Marin County, CA · this page$127.46
- Bakersfield, CA · California$106.59−$20.87
- Chico, CA · California$106.12−$21.34
- El Centro, CA · California$106.15−$21.31
- Fresno, CA · California$106.12−$21.34
- Hanford, CA · California$106.12−$21.34
- Los Angeles, CA · California$112.92−$14.54
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | $106.12 | $70.98 |
| 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 |
| Salinas, CACalifornia | $110.43 | $73.26 |
| San Diego, CACalifornia | $112.65 | $74.30 |
| San Francisco, CACalifornia | $127.27 | $82.06 |
| San Benito County, CACalifornia | $130.34 | $84.10 |
| Santa Clara County, CACalifornia | $129.60 | $83.36 |
| San Luis Obispo, CACalifornia | $108.71 | $72.19 |
| Santa Cruz, CACalifornia | $113.42 | $74.47 |
| Santa Maria, CACalifornia | $110.74 | $73.35 |
| Santa Rosa, CACalifornia | $114.54 | $75.16 |
| Stockton, CACalifornia | $106.12 | $70.98 |
| Vallejo, CACalifornia | $120.75 | $78.49 |
| Visalia, CACalifornia | $106.12 | $70.98 |
| Yuba City, CACalifornia | $106.12 | $70.98 |
| Washington, DC areaDistrict of Columbia | $115.50 | $77.72 |
| Miami, FLFlorida | $112.84 | $79.46 |
| Chicago, ILIllinois | $109.69 | $77.46 |
| Manhattan, NYNew York | $117.43 | $80.17 |
| AlaskaAlaska | $122.09 | $87.94 |
| AlabamaAlabama | $92.37 | $64.32 |
| ArkansasArkansas | $91.14 | $63.59 |
| ArizonaArizona | $99.57 | $68.50 |
| ColoradoColorado | $105.33 | $71.21 |
| ConnecticutConnecticut | $108.69 | $74.16 |
| DelawareDelaware | $101.13 | $69.45 |
| Fort Lauderdale, FLFlorida | $107.31 | $74.82 |
| Rest of FloridaFlorida | $102.25 | $71.60 |
| Atlanta, GAGeorgia | $104.35 | $71.78 |
| Rest of GeorgiaGeorgia | $96.74 | $68.14 |
| Hawaii, Guam, HIHawaii | $108.19 | $71.74 |
| IowaIowa | $93.87 | $64.53 |
| IdahoIdaho | $94.58 | $65.08 |
| East St. Louis, ILIllinois | $102.82 | $73.32 |
| Rest of IllinoisIllinois | $99.98 | $70.71 |
| Suburban Chicago, ILIllinois | $108.21 | $75.28 |
| IndianaIndiana | $95.07 | $65.35 |
| KansasKansas | $93.78 | $64.80 |
| KentuckyKentucky | $95.08 | $66.57 |
| New Orleans, LALouisiana | $99.39 | $69.21 |
| Rest of LouisianaLouisiana | $95.07 | $66.69 |
| Metropolitan Boston, MAMassachusetts | $114.79 | $76.50 |
| Rest of MassachusettsMassachusetts | $104.90 | $71.13 |
| Baltimore area, MDMaryland | $108.45 | $74.04 |
| Rest of MarylandMaryland | $102.86 | $70.41 |
| Rest of MaineMaine | $95.38 | $65.88 |
| Southern Maine, MEMaine | $99.69 | $67.92 |
| Detroit, MIMichigan | $103.77 | $72.83 |
| Rest of MichiganMichigan | $97.67 | $68.39 |
| MinnesotaMinnesota | $100.19 | $67.19 |
| Metropolitan Kansas City, MOMissouri | $98.42 | $68.31 |
| Metropolitan St. Louis, MOMissouri | $99.33 | $68.81 |
| Rest of MissouriMissouri | $93.77 | $66.13 |
| MississippiMississippi | $92.46 | $64.85 |
| MontanaMontana | $102.20 | $70.13 |
| North CarolinaNorth Carolina | $96.25 | $66.33 |
| North DakotaNorth Dakota | $99.03 | $66.97 |
| NebraskaNebraska | $94.25 | $64.66 |
| New HampshireNew Hampshire | $104.00 | $70.62 |
| Northern New JerseyNew Jersey | $114.50 | $77.31 |
| Rest of New JerseyNew Jersey | $109.73 | $74.71 |
| New MexicoNew Mexico | $98.29 | $68.89 |
| NevadaNevada | $101.37 | $69.28 |
| NYC suburbs and Long Island, NYNew York | $120.50 | $82.38 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $110.69 | $75.58 |
| Queens, NYNew York | $117.86 | $79.96 |
| Rest of New YorkNew York | $97.61 | $67.15 |
| OhioOhio | $97.02 | $67.74 |
| OklahomaOklahoma | $94.58 | $65.95 |
| Portland, OROregon | $108.10 | $72.48 |
| Rest of OregonOregon | $100.38 | $68.44 |
| Metropolitan Philadelphia, PAPennsylvania | $106.36 | $72.98 |
| Rest of PennsylvaniaPennsylvania | $96.98 | $67.55 |
| Puerto RicoPuerto Rico | $102.79 | $70.37 |
| Rhode IslandRhode Island | $104.31 | $71.19 |
| South CarolinaSouth Carolina | $96.84 | $67.21 |
| South DakotaSouth Dakota | $98.66 | $66.59 |
| TennesseeTennessee | $94.26 | $65.11 |
| Austin, TXTexas | $105.16 | $71.23 |
| Beaumont, TXTexas | $96.42 | $67.24 |
| Brazoria, TXTexas | $100.78 | $69.01 |
| Dallas, TXTexas | $101.54 | $69.60 |
| Fort Worth, TXTexas | $101.01 | $69.39 |
| Galveston, TXTexas | $101.16 | $69.32 |
| Houston, TXTexas | $104.09 | $72.25 |
| Rest of TexasTexas | $98.62 | $68.19 |
| UtahUtah | $98.05 | $67.91 |
| VirginiaVirginia | $99.61 | $68.09 |
| Virgin Islands, VIUnited States Virgin Islands | $102.79 | $70.37 |
| VermontVermont | $98.97 | $67.22 |
| Rest of WashingtonWashington | $104.59 | $70.83 |
| King County, WAWashington | $116.71 | $77.37 |
| WisconsinWisconsin | $95.98 | $65.27 |
| West VirginiaWest Virginia | $96.63 | $68.77 |
| WyomingWyoming | $100.82 | $68.75 |
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.
The exact Marin County, 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
25
- Locality
- Marin County, CA
- Physician work
- 1.095
- Practice expense
- 1.410
- Malpractice
- 0.459
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.10 | × 1.095 | 1.2045 |
| Practice expense | 1.80 | × 1.410 | 2.5380 |
| Malpractice | 0.16 | × 0.459 | 0.0734 |
| Total RVUs | 3.8159 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Marin County, CA$127.46
Office: (1.1 × 1.095 + 1.8 × 1.41 + 0.16 × 0.459) × $33.4009 = $127.46
Facility: (1.1 × 1.095 + 0.84 × 1.41 + 0.16 × 0.459) × $33.4009 = $82.24
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%).
How 42660 has changed in Marin County, CA
42660 · Office / nonfacility
$127.46
Effective 2026-10-01
The base rate is $7.23 higher than on 2025-10-01, moving from $120.23 to $127.46 (6.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$120.23changed to$127.46
- 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 1.088 changed to 1.095
- Practice expense GPCI 1.419 changed to 1.410
- Malpractice GPCI 0.470 changed to 0.459
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$138.20changed to$120.23
- 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.
March 9, 2024
RVU24AR
$135.95changed to$138.20
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$143.40changed to$135.95
- 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 1.082 changed to 1.088
- Practice expense GPCI 1.374 changed to 1.419
- Malpractice GPCI 0.487 changed to 0.470
January 1, 2023
RVU23A
$141.74changed to$143.40
- 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 1.077 changed to 1.082
- Practice expense GPCI 1.329 changed to 1.374
- Malpractice GPCI 0.504 changed to 0.487
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$143.96changed to$141.74
- 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
- Work GPCI 1.071 changed to 1.077
- Practice expense GPCI 1.311 changed to 1.329
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$146.74changed to$143.96
- 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 1.068 changed to 1.071
- Practice expense GPCI 1.299 changed to 1.311
- Malpractice GPCI 0.481 changed to 0.504
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$148.85changed to$146.74
- 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 1.065 changed to 1.068
- Practice expense GPCI 1.291 changed to 1.299
- Malpractice GPCI 0.458 changed to 0.481
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$152.41changed to$148.85
- 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
- Work GPCI 1.062 changed to 1.065
- Practice expense GPCI 1.279 changed to 1.291
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$150.45changed to$152.41
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.23 changed to 2.25
- Work GPCI 1.058 changed to 1.062
- Practice expense GPCI 1.271 changed to 1.279
- Malpractice GPCI 0.477 changed to 0.458
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$150.45
Held through RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $127.46 | $82.24 | RVU26D |
| 2026-07-01 | $127.46 | $82.24 | RVU26C |
| 2026-04-01 | $127.46 | $82.24 | RVU26B |
| 2026-01-01 | $127.46 | $82.24 | RVU26A |
| 2025-10-01 | $120.23 | $92.69 | RVU25D |
| 2025-07-01 | $120.23 | $92.69 | RVU25C |
| 2025-04-01 | $120.23 | $92.69 | RVU25B |
| 2025-01-01 | $120.23 | $92.69 | RVU25A |
| 2024-10-01 | $138.20 | $101.83 | RVU24D |
| 2024-07-01 | $138.20 | $101.83 | RVU24C |
| 2024-04-01 | $138.20 | $101.83 | RVU24B |
| 2024-03-09 | $138.20 | $101.83 | RVU24AR |
| 2024-01-01 | $135.95 | $100.17 | RVU24A |
| 2023-10-01 | $143.40 | $102.89 | RVU23D |
| 2023-07-01 | $143.40 | $102.89 | RVU23C |
| 2023-04-01 | $143.40 | $102.89 | RVU23B |
| 2023-01-01 | $143.40 | $102.89 | RVU23A |
| 2022-10-01 | $141.74 | $100.81 | RVU22D |
| 2022-07-01 | $141.74 | $100.81 | RVU22C |
| 2022-04-01 | $141.74 | $100.81 | RVU22B |
| 2022-01-01 | $141.74 | $100.81 | RVU22A |
| 2021-10-01 | $143.96 | $98.67 | RVU21D |
| 2021-07-01 | $143.96 | $98.67 | RVU21C |
| 2021-04-01 | $143.96 | $98.67 | RVU21B |
| 2021-01-01 | $143.96 | $98.67 | RVU21A |
| 2020-10-01 | $146.74 | $99.86 | RVU20D |
| 2020-07-01 | $146.74 | $99.86 | RVU20C |
| 2020-04-01 | $146.74 | $99.86 | RVU20B |
| 2020-01-01 | $146.74 | $99.86 | RVU20A |
| 2019-10-01 | $148.85 | $100.46 | RVU19D |
| 2019-07-01 | $148.85 | $100.46 | RVU19C |
| 2019-04-01 | $148.85 | $100.46 | RVU19B |
| 2019-01-01 | $148.85 | $100.46 | RVU19A |
| 2018-10-01 | $152.41 | $100.84 | RVU18D |
| 2018-07-01 | $152.41 | $100.84 | RVU18C |
| 2018-04-01 | $152.41 | $100.84 | RVU18B |
| 2018-01-01 | $152.41 | $100.84 | RVU18AR1 |
| 2017-10-01 | $150.45 | $100.27 | RVU17D |
| 2017-07-01 | $150.45 | $100.27 | RVU17C |
| 2017-04-01 | $150.45 | $100.27 | RVU17B |
| 2017-01-01 | $150.45 | $100.27 | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Marin County, CA rate applies
Marin County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 31 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Alto
- Belvedere
- Black Point-Green Point
- Bolinas
- Corte Madera
- Dillon Beach
- Fairfax
- Inverness
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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