No office rate
Both involve total parotid excision. Choose 42425 when the facial nerve is sacrificed; choose 42420 when it is dissected and preserved.
On this page
CMS RVU26D · Effective 2026-10-01
42425 Parotidectomy Medicare reimbursement rates
Reports complete removal of a parotid gland and tumor with facial nerve sacrifice, typically when the tumor involves the nerve. Compare 42425 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 42425?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 42425 pays more and less
Head and neck surgery
About 42425: Total parotidectomy with facial nerve sacrifice
Reports complete removal of a parotid gland and tumor with facial nerve sacrifice, typically when the tumor involves the nerve.
This operation removes the entire parotid gland and tumor while sacrificing the facial nerve, typically because the tumor involves or encases the nerve. An otolaryngologist or head-and-neck surgeon performs it in an operating room, often for an extensive parotid neoplasm. Sacrificing the nerve can cause facial weakness or paralysis on the operated side.
Report this code when the operative report supports total gland excision and facial nerve sacrifice; lateral-lobe removal or nerve preservation belongs to other parotidectomy codes. Document the extent of resection, nerve management, tumor involvement, and any neck dissection. CMS classifies the procedure as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 42425
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.08 · 60%
- Practice expense (office) RVU6.85 · 31%
- Malpractice RVU1.94 · 9%
241
Medicare services in 2024 · #4161 by national volume
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.
42425 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code identifies total parotid excision with unilateral radical neck dissection. Code 42425 identifies total excision with facial nerve sacrifice.
No office rate
42415 is for lateral-lobe excision with facial nerve dissection and preservation, rather than total gland excision with nerve sacrifice.
No office rate
42410 describes lateral-lobe excision without facial nerve dissection; 42425 describes total excision with facial nerve sacrifice.
See how rates vary across the country
42425 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 42425 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $673.76 |
| Alaska* | Office Unavailable | Facility $934.70 |
| Arizona | Office Unavailable | Facility $714.05 |
| Arkansas | Office Unavailable | Facility $666.79 |
| Atlanta | Office Unavailable | Facility $748.47 |
| Austin | Office Unavailable | Facility $737.23 |
| Bakersfield | Office Unavailable | Facility $735.41 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $769.53 |
| Beaumont | Office Unavailable | Facility $705.29 |
| Brazoria | Office Unavailable | Facility $717.66 |
| Chicago | Office Unavailable | Facility $818.59 |
| Chico | Office Unavailable | Facility $729.80 |
| Colorado | Office Unavailable | Facility $736.17 |
| Connecticut | Office Unavailable | Facility $770.44 |
| Dallas | Office Unavailable | Facility $724.29 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $802.12 |
| Delaware | Office Unavailable | Facility $723.37 |
| Detroit | Office Unavailable | Facility $766.92 |
| East St. Louis | Office Unavailable | Facility $777.88 |
| El Centro | Office Unavailable | Facility $730.13 |
| Fort Lauderdale | Office Unavailable | Facility $785.81 |
| Fort Worth | Office Unavailable | Facility $722.85 |
| Fresno | Office Unavailable | Facility $729.80 |
| Galveston | Office Unavailable | Facility $721.23 |
| Hanford-Corcoran | Office Unavailable | Facility $729.80 |
| Hawaii, Guam | Office Unavailable | Facility $734.54 |
| Houston | Office Unavailable | Facility $756.74 |
| Idaho | Office Unavailable | Facility $678.03 |
| Indiana | Office Unavailable | Facility $680.47 |
| Iowa | Office Unavailable | Facility $671.96 |
| Kansas | Office Unavailable | Facility $676.37 |
| Kentucky | Office Unavailable | Facility $699.57 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $768.49 |
| Madera | Office Unavailable | Facility $729.80 |
| Manhattan | Office Unavailable | Facility $833.47 |
| Merced | Office Unavailable | Facility $729.80 |
| Metropolitan Boston | Office Unavailable | Facility $785.65 |
| Metropolitan Kansas City | Office Unavailable | Facility $715.03 |
| Metropolitan Philadelphia | Office Unavailable | Facility $760.23 |
| Metropolitan St. Louis | Office Unavailable | Facility $719.63 |
| Miami | Office Unavailable | Facility $838.93 |
| Minnesota | Office Unavailable | Facility $691.50 |
| Mississippi | Office Unavailable | Facility $681.76 |
| Modesto | Office Unavailable | Facility $729.80 |
| Montana** | Office Unavailable | Facility $730.35 |
| Napa | Office Unavailable | Facility $798.88 |
| Nebraska | Office Unavailable | Facility $672.56 |
| Nevada** | Office Unavailable | Facility $719.89 |
| New Hampshire | Office Unavailable | Facility $731.76 |
| New Mexico | Office Unavailable | Facility $724.51 |
| New Orleans | Office Unavailable | Facility $725.79 |
| North Carolina | Office Unavailable | Facility $691.76 |
| North Dakota** | Office Unavailable | Facility $691.99 |
| Northern Nj | Office Unavailable | Facility $799.01 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $857.21 |
| Ohio | Office Unavailable | Facility $711.09 |
| Oklahoma | Office Unavailable | Facility $691.55 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $759.92 |
| Portland | Office Unavailable | Facility $746.28 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $785.48 |
| Puerto Rico | Office Unavailable | Facility $732.02 |
| Queens | Office Unavailable | Facility $828.72 |
| Redding | Office Unavailable | Facility $729.80 |
| Rest Of California | Office Unavailable | Facility $729.80 |
| Rest Of Florida | Office Unavailable | Facility $753.00 |
| Rest Of Georgia | Office Unavailable | Facility $718.21 |
| Rest Of Illinois | Office Unavailable | Facility $747.05 |
| Rest Of Louisiana | Office Unavailable | Facility $701.44 |
| Rest Of Maine | Office Unavailable | Facility $687.68 |
| Rest Of Maryland | Office Unavailable | Facility $732.28 |
| Rest Of Massachusetts | Office Unavailable | Facility $736.44 |
| Rest Of Michigan | Office Unavailable | Facility $718.93 |
| Rest Of Missouri | Office Unavailable | Facility $697.22 |
| Rest Of New Jersey | Office Unavailable | Facility $775.29 |
| Rest Of New York | Office Unavailable | Facility $699.79 |
| Rest Of Oregon | Office Unavailable | Facility $710.32 |
| Rest Of Pennsylvania | Office Unavailable | Facility $708.15 |
| Rest Of Texas | Office Unavailable | Facility $712.52 |
| Rest Of Washington | Office Unavailable | Facility $732.80 |
| Rhode Island | Office Unavailable | Facility $739.33 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $750.78 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $753.43 |
| Salinas | Office Unavailable | Facility $750.33 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $758.75 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $830.73 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $828.53 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $849.60 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $840.59 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $739.64 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $758.78 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $750.62 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $765.68 |
| Seattle (King Cnty) | Office Unavailable | Facility $792.40 |
| South Carolina | Office Unavailable | Facility $703.37 |
| South Dakota** | Office Unavailable | Facility $687.45 |
| Southern Maine | Office Unavailable | Facility $704.51 |
| Stockton | Office Unavailable | Facility $729.80 |
| Suburban Chicago | Office Unavailable | Facility $789.74 |
| Tennessee | Office Unavailable | Facility $679.66 |
| Utah | Office Unavailable | Facility $710.14 |
| Vallejo | Office Unavailable | Facility $795.70 |
| Vermont | Office Unavailable | Facility $696.18 |
| Virgin Islands | Office Unavailable | Facility $732.02 |
| Virginia | Office Unavailable | Facility $707.54 |
| Visalia | Office Unavailable | Facility $729.80 |
| West Virginia | Office Unavailable | Facility $728.43 |
| Wisconsin | Office Unavailable | Facility $676.03 |
| Wyoming** | Office Unavailable | Facility $713.63 |
| Yuba City | Office Unavailable | Facility $729.80 |
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42425 billing questions
How does this differ from 42420?
Both describe total parotid excision, but 42425 is for sacrifice of the facial nerve. Code 42420 describes total excision with facial nerve dissection and preservation.
When is 42426 more appropriate?
Use 42426 when the total parotid excision is performed with a unilateral radical neck dissection. Document the neck dissection as part of the operation.
What documentation supports 42425?
The operative report should establish complete parotid excision and facial nerve sacrifice, including the nerve management and tumor extent.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The documentation should support surgery on both sides.
How does the global period affect follow-up billing?
The 90-day major-surgery global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,03242410,,Excise parotid gland/lesion,A,,9.33,5.90,NA,5.90,,1.45,16.68,16.68,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03342415,,Excise parotid gland/lesion,A,,16.73,8.31,NA,8.31,,2.51,27.55,27.55,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03442420,,Excise parotid gland/lesion,A,,19.04,8.84,NA,8.84,,2.83,30.71,30.71,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03542425,,Excise parotid gland/lesion,A,,13.08,6.85,NA,6.85,,1.94,21.87,21.87,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03642426,,Excise parotid gland/lesion,A,,22.09,9.34,NA,9.34,,3.48,34.91,34.91,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0374242F,,Sprvsd xrcz back pn >12 wks,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03842440,,Excise submaxillary gland,A,,5.99,4.21,NA,4.21,,0.89,11.09,11.09,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00