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Billing code 42420: Parotid excisionMedicare rate & RVUs

Report total parotid excision when the surgeon removes the gland and dissects and preserves the facial nerve, rather than removing only the lateral lobe.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $1,025.74 for 42420 nationally in a facility.

Medicare rate · 42420

Parotid excision

Swap in your local Medicare rate.

Work RVUs
19.04
Total RVUs
30.71
Global days
090

National rate · 2026

$1,025.74

Facility setting, before claim adjustments.

See every locality for 42420 → · 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 42420 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 42420 covers

This operation removes the parotid gland in its entirety, including its superficial and deep portions, while the surgeon identifies, dissects, and preserves the facial nerve. Otolaryngologists and head and neck surgeons typically perform it in an operating room for a parotid neoplasm or other disease requiring removal of the whole gland. The operative report should establish the extent of gland removal and document facial nerve dissection and preservation.

Select this code for total gland excision with nerve preservation, not a lateral-lobe excision or an operation that sacrifices the nerve. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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 42420 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

42420 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$947.81
Alaska*Unavailable$1,320.47
ArizonaUnavailable$1,002.98
ArkansasUnavailable$938.27
AtlantaUnavailable$1,051.37
AustinUnavailable$1,033.36
BakersfieldUnavailable$1,029.21
Baltimore/Surr. CntysUnavailable$1,079.87
BeaumontUnavailable$992.46
BrazoriaUnavailable$1,007.38

42420 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
42420 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 42420 rate is calculated

Each of 42420’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 · 42420

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 19.04Practice expense 8.84Malpractice 2.83

30.7100 adjusted RVUs×$33.4009 conversion factor=$1,025.74

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

Payment rules and modifiers for 42420

42420 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 42420

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 · 42420

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

42420 without 50 · national facility

$1,025.74

Parotid excision

42420-50 · Bilateral: 150%

$1,538.61

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

42420 compared with similar codes

Compare codes

42420 vs 42415 vs 42425 vs 42426 vs 42410: national Medicare rates

Swap in your local Medicare rate.

  • 42420
    Parotid excision · 19.04 wRVU
    —
  • 42415
    Parotid excision · 16.73 wRVU
    —
  • 42425
    Parotidectomy · 13.08 wRVU
    —
  • 42426
    Parotidectomy · 22.09 wRVU
    —
  • 42410
    Parotid excision · 9.33 wRVU
    —

How to choose

42415Parotid excision
Use 42415 when excision is limited to the lateral lobe with facial nerve dissection and preservation. This code describes total gland removal.
42425Parotidectomy
This code describes total parotid excision with facial nerve preservation; 42425 is for total excision involving sacrifice of the facial nerve.
42426Parotidectomy
This code describes total parotid excision with facial nerve preservation. The 42426 service includes a unilateral radical neck dissection.
42410Parotid excision
Use 42410 for lateral-lobe excision without facial nerve dissection and preservation. This code involves total gland removal with nerve dissection and preservation.

Codes related to 42420

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

Codes related to 42420
CodeHow it relatesNational office range
Same family
42410Parotid excisionLateral-lobe parotid excision without facial nerve dissection and preservation.No office rate
42415Parotid excisionLateral-lobe parotid excision with facial nerve dissection and preservation.No office rate
42425ParotidectomyTotal parotid excision when the facial nerve is sacrificed.No office rate
42426ParotidectomyParotid excision associated with unilateral radical neck dissection.No office rate

42420 billing questions

How does this differ from a lateral-lobe parotid excision?

This code describes removal of the whole parotid gland with facial nerve dissection and preservation. A lateral-lobe code is for removal limited to that portion of the gland.

Can this code be used when the facial nerve is sacrificed?

No. This code requires dissection and preservation of the facial nerve. Use the applicable code for total excision involving nerve sacrifice when that is what the operative report documents.

Does the 90-day global period include postoperative visits?

Yes. Related postoperative care through 90 days is included, along with the day-before preoperative visit.

How is this paid when other procedures are performed in the same session?

The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction. The operative record should support each separately reported procedure.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment for this code.

How should bilateral surgery be reported?

For bilateral performance, report modifier 50; CMS pays the bilateral 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 42420PPRRVU2026_Oct_nonQPP.csv, line 5,034 (RVU26D)

Open CMS sourceHow we calculate rates

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