FeeBase
Log inGet started
Menu

CPT code 42660: Salivary duct dilation, complicated procedure2026 Medicare rate & RVUs in Puerto Rico

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 Puerto Rico, Medicare pays $102.79 for 42660 in the office and $70.37 when it’s performed in a hospital or facility.

$102.79Office (non-facility)
$70.37Hospital or facility
+0.6%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $102.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

42660 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$102.79
  2. Los Angeles, CA · California$112.92+$10.13
  3. Washington, DC area · District of Columbia$115.50+$12.71
  4. Miami, FL · Florida$112.84+$10.05
  5. Chicago, IL · Illinois$109.69+$6.90
  6. Manhattan, NY · New York$117.43+$14.64
  7. Alaska · Alaska$122.09+$19.30

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

Every other payment area

42660 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$92.37$64.32
ArkansasArkansas$91.14$63.59
ArizonaArizona$99.57$68.50
Bakersfield, CACalifornia$106.59$71.44
Chico, CACalifornia$106.12$70.98
El Centro, CACalifornia$106.15$71.01
Fresno, CACalifornia$106.12$70.98
Hanford, CACalifornia$106.12$70.98

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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 42660 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.10× 1.0001.1000
Practice expense1.80× 1.0111.8198
Malpractice0.16× 0.9850.1576
Total RVUs3.0774
Conversion factor× 33.4009

Office rate, Puerto Rico$102.79

Office: (1.1 × 1 + 1.8 × 1.011 + 0.16 × 0.985) × $33.4009 = $102.79

Facility: (1.1 × 1 + 0.84 × 1.011 + 0.16 × 0.985) × $33.4009 = $70.37

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, Puerto Rico
Same family
42650Salivary duct dilation, percutaneous approachThe less complex salivary duct dilation level.$77.30
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.$371.19

How 42660 has changed in Puerto Rico

42660 · Office / nonfacility

$102.79

Effective 2026-10-01

The base rate is $5.78 higher than on 2025-10-01, moving from $97.01 to $102.79 (6.0%).

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

    $97.01changed to$102.79

    • 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
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $112.48changed to$97.01

    • 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

    $110.64changed to$112.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $119.68changed to$110.64

    • 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
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $119.28changed to$119.68

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $120.52changed to$119.28

    • 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
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $123.28changed to$120.52

    • 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.

  8. January 1, 2021

    RVU21A

    $127.51changed to$123.28

    • 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
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $130.52changed to$127.51

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $134.36changed to$130.52

    • 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.

  11. January 1, 2018

    RVU18AR1

    $116.90changed to$134.36

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.23 changed to 2.25
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $100.82changed to$116.90

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.25 changed to 2.23
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $100.17changed to$100.82

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

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $99.67changed to$100.17

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $97.77changed to$99.67

    • 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
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $97.07changed to$97.77

    • 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
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $97.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$102.79$70.37RVU26D
2026-07-01$102.79$70.37RVU26C
2026-04-01$102.79$70.37RVU26B
2026-01-01$102.79$70.37RVU26A
2025-10-01$97.01$77.46RVU25D
2025-07-01$97.01$77.46RVU25C
2025-04-01$97.01$77.46RVU25B
2025-01-01$97.01$77.46RVU25A
2024-10-01$112.48$86.67RVU24D
2024-07-01$112.48$86.67RVU24C
2024-04-01$112.48$86.67RVU24B
2024-03-09$112.48$86.67RVU24AR
2024-01-01$110.64$85.25RVU24A
2023-10-01$119.68$89.96RVU23D
2023-07-01$119.28$89.80RVU23C
2023-04-01$119.28$89.80RVU23B
2023-01-01$119.28$89.80RVU23A
2022-10-01$120.52$89.47RVU22D
2022-07-01$120.52$89.47RVU22C
2022-04-01$120.52$89.47RVU22B
2022-01-01$120.52$89.47RVU22A
2021-10-01$123.28$88.46RVU21D
2021-07-01$123.28$88.46RVU21C
2021-04-01$123.28$88.46RVU21B
2021-01-01$123.28$88.46RVU21A
2020-10-01$127.51$91.13RVU20D
2020-07-01$127.51$91.13RVU20C
2020-04-01$127.51$91.13RVU20B
2020-01-01$127.51$91.13RVU20A
2019-10-01$130.52$92.78RVU19D
2019-07-01$130.52$92.78RVU19C
2019-04-01$130.52$92.78RVU19B
2019-01-01$130.52$92.78RVU19A
2018-10-01$134.36$93.76RVU18D
2018-07-01$134.36$93.76RVU18C
2018-04-01$134.36$93.76RVU18B
2018-01-01$134.36$93.76RVU18AR1
2017-10-01$116.90$83.10RVU17D
2017-07-01$116.90$83.10RVU17C
2017-04-01$116.90$83.10RVU17B
2017-01-01$116.90$83.10RVU17A
2016-10-01$100.82$72.80RVU16D
2016-07-01$100.82$72.80RVU16C
2016-04-01$100.82$72.80RVU16B
2016-01-01$100.82$72.80RVU16A
2015-10-01$100.17$72.81RVU15D
2015-07-01$100.17$72.81RVU15C
2015-04-01$99.67$72.45RVU15B
2015-01-01$99.67$72.45RVU15A
2014-10-01$97.77$70.25RVU14D
2014-07-01$97.77$70.25RVU14C
2014-04-01$97.77$70.25RVU14B
2014-01-01$97.77$70.25RVU14A
2013-10-01$97.07$68.47RVU13D
2013-07-01$97.07$68.47RVU13C
2013-04-01$97.07$68.47RVU13B
2013-01-01$97.07$68.47RVU13AR

Price 42660 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 42660 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 42660 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet