CPT code 42699: Salivary procedure, unlisted procedure2026 Medicare rate & RVUs in Michigan
Reports an operation on a salivary gland or duct when no more specific CPT procedure code describes the service performed.
CMS doesn’t publish an office rate for 42699 in Michigan.
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 9 sections
What 42699 covers
CPT 42699 is used for an operation involving a salivary gland or duct when the procedure performed does not match a more specific listed CPT code. Otolaryngologists and oral and maxillofacial surgeons may report it for an uncommon or technically distinct procedure in an operating room or, less often, an office setting. It is not a substitute for a listed code simply because the service is unusual; the actual work must be outside the scope of available specific codes.
Medicare assigns this code Physician Fee Schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The claim should identify the operation and include supporting operative documentation for the contractor’s review. The contractor sets the global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%.
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 42699 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
How the 42699 rate is calculated
Each of 42699’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 · 42699
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42699
The CMS indicators that decide how 42699 is paid alongside other services.
CMS payment indicators · 42699
Salivary procedure, unlisted procedure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42699 without 51 · national facility
$0.00
Salivary procedure, unlisted procedure
42699-51 · Second procedure: 50%
$0.00
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%).
42699 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 42600Fistula closureSalivary tract
- 42600 describes closure of a salivary fistula. Choose 42699 only when the operation is not described by that specific service or another listed code.
- 42650Salivary duct dilationPercutaneous approach
- 42650 is a specific salivary duct dilation code. Use 42699 only when the dilation or other operation performed does not match an available listed code.
- 42660Salivary duct dilationComplicated procedure
- 42660 is another specific salivary duct dilation code. Select between the listed dilation codes based on the procedure performed; reserve 42699 for an operation without a matching specific code.
- 42665Salivary duct surgeryDuct interruption
- 42665 describes salivary duct ligation. It is more specific than 42699 when duct ligation is the service performed.
42699 billing questions
When should 42699 be used instead of a listed salivary procedure code?
Use 42699 only when no specific CPT code describes the operation performed. Use a listed code when the service matches its defined procedure, such as fistula closure, duct dilation, or duct ligation.
What documentation should accompany a 42699 claim?
Describe the procedure performed and provide supporting operative documentation so the Medicare contractor can evaluate the service and set payment.
How does Medicare price 42699?
It has Physician Fee Schedule status C, meaning CMS publishes no national payment and the Medicare Administrative Contractor sets payment for each claim.
Who sets the global period for this code?
The Medicare contractor sets the global period for 42699.
How is 42699 handled with other procedures in the same session?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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
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