CPT code 42330: Salivary stone removal2026 Medicare rate & RVUs

Medicare pays $237.81 for 42330 nationally in the office and $150.30 in a hospital or facility. Local office rates run $210.85–$308.55.

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

What 42330 covers

An otolaryngologist or oral and maxillofacial surgeon uses an incision inside the mouth to reach and extract a salivary calculus in the sublingual or submandibular duct region. A typical clinical situation is an obstructing duct stone causing meal-related gland swelling or recurrent symptoms when the stone cannot be removed by simpler means. The code distinguishes this intraoral approach from extraoral removal and from procedures directed at a parotid stone.

Select the code based on the documented stone site and surgical approach. The operative note should identify the affected duct or gland, the calculus, and the intraoral incision and extraction performed. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 42330 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

42330 rates by state

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

How the 42330 rate is calculated

Each of 42330’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.

Payment rules and modifiers for 42330

42330 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

42330 compared with similar codes

How to choose

42335Stone removal

Both address sublingual or submandibular calculi, but 42330 is the intraoral approach and 42335 is the extraoral approach.

42340Stone removal

Use 42340 for a parotid calculus removed extraorally; 42330 is for an intraoral procedure in the sublingual or submandibular region.

42310Salivary drainage

42310 describes drainage of a sublingual or submandibular abscess through an intraoral approach. Use 42330 when the procedure removes a calculus rather than draining an abscess.

42320Abscess drainage

42320 describes extraoral drainage of a sublingual or submandibular abscess; it is not the code for intraoral calculus extraction.

Codes related to 42330

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

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

Open CMS sourceHow we calculate rates