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Billing code 42415: Parotid excisionMedicare rate & RVUs

Reports removal of a parotid lesion or lateral gland lobe when the surgeon dissects and preserves the facial nerve during surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities5.7K Medicare services in 2024

Medicare pays $920.19 for 42415 nationally in a facility.

Medicare rate · 42415

Parotid excision

Swap in your local Medicare rate.

Work RVUs
16.73
Total RVUs
27.55
Global days
090

National rate · 2026

$920.19

Facility setting, before claim adjustments.

See every locality for 42415 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 42415 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 42415 covers

An otolaryngologist or head and neck surgeon reports this operation when removing a lesion from the lateral lobe of the parotid, or removing that lobe, while dissecting and preserving the facial nerve. It may be performed for a parotid mass, such as a benign salivary tumor, in a hospital or other surgical setting. The nerve dissection and preservation are defining features of this service, not simply incidental details of a lesion excision.

Choose the code based on the operative extent and documented facial nerve management, not pathology results alone. The operative report should identify the parotid tissue removed and describe the nerve dissection and preservation. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is 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 42415 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

42415 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$849.11
Alaska*Unavailable$1,179.99
ArizonaUnavailable$899.52
ArkansasUnavailable$840.40
AtlantaUnavailable$943.16
AustinUnavailable$927.85
BakersfieldUnavailable$924.68
Baltimore/Surr. CntysUnavailable$969.27
BeaumontUnavailable$889.26
BrazoriaUnavailable$903.72

42415 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
42415 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 42415 rate is calculated

Each of 42415’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 · 42415

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.73Practice expense 8.31Malpractice 2.51

27.5500 adjusted RVUs×$33.4009 conversion factor=$920.19

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 42415

42415 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 42415

Parotid excision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 42415

Parotid excision

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

42415 without 50 · national facility

$920.19

Parotid excision

42415-50 · Bilateral: 150%

$1,380.29

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

42415 compared with similar codes

Compare codes

42415 vs 42410 vs 42420 vs 42400: national Medicare rates

Swap in your local Medicare rate.

  • 42415
    Parotid excision · 16.73 wRVU
    —
  • 42410
    Parotid excision · 9.33 wRVU
    —
  • 42420
    Parotid excision · 19.04 wRVU
    —
  • 42400
    Salivary biopsy · 0.76 wRVU
    $94.52

How to choose

42410Parotid excision
Both describe lateral-lobe parotid excision, but 42415 includes facial nerve dissection and preservation; 42410 does not.
42420Parotid excision
42420 describes total parotid excision with facial nerve dissection and preservation. Choose 42415 when the operation is limited to the lateral lobe.
42400Salivary biopsy
42400 is for biopsy of a salivary gland to obtain tissue for diagnosis; 42415 is an operation removing parotid tissue or a lesion with facial nerve dissection and preservation.

Codes related to 42415

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

Codes related to 42415
CodeHow it relatesNational office range
Same family
42410Parotid excisionLateral-lobe parotid excision without dissection and preservation of the facial nerve.No office rate
42420Parotid excisionTotal parotid excision with dissection and preservation of the facial nerve.No office rate
42425ParotidectomyTotal parotid excision involving sacrifice of the facial nerve.No office rate
42426ParotidectomyRadical parotid resection; selected for a more extensive operation.No office rate
Used instead
42400Salivary biopsySalivary-gland biopsy is a diagnostic sampling service, rather than lateral-lobe excision.$83.86–$125.46

42415 billing questions

How does 42415 differ from 42410?

42415 includes dissection and preservation of the facial nerve during lateral-lobe excision. 42410 is for lateral-lobe excision without that nerve dissection and preservation.

When is 42420 more appropriate?

Use 42420 when the operative service removes the total parotid gland with facial nerve dissection and preservation, rather than excising the lateral lobe.

Is facial nerve dissection separately reported?

The dissection and preservation of the facial nerve are part of the service represented by 42415. The operative report should document that work and the extent of parotid removal.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

How is bilateral surgery handled?

For bilateral performance, modifier 50 applies, and CMS pays the procedure at 150%.

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 42415PPRRVU2026_Oct_nonQPP.csv, line 5,033 (RVU26D)

Open CMS sourceHow we calculate rates

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