Billing code 42440: Salivary gland excisionMedicare rate & RVUs

Medicare pays $370.42 for 42440 nationally in a facility.

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

What 42440 covers

This code describes surgical removal of a submandibular gland, also called the submaxillary gland. Otolaryngologists and head-and-neck surgeons commonly perform the operation in an operating room for recurrent obstructive symptoms, chronic sialadenitis, or a tumor involving the gland. The operative report should establish that the gland itself was excised, rather than only a stone, cyst, or diagnostic tissue sample. The opposite submandibular gland is a separate site for bilateral reporting.

Select the code based on the gland removed, not the diagnosis alone. Document the indication, side, operative extent, and any distinct procedures performed during the same session. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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%. 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 42440 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

42440 rates by state

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

How the 42440 rate is calculated

Each of 42440’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 42440

42440 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

42440 compared with similar codes

How to choose

42400Salivary biopsy

This code is for removal of the submandibular gland; 42400 describes needle biopsy of salivary gland tissue.

42405Salivary gland biopsy

Use this code for gland excision. Code 42405 describes incisional biopsy rather than removal of the gland.

42408Salivary cyst

Code 42408 describes excision of a salivary cyst. Choose this code when the submandibular gland itself is removed.

42450Gland excision

Both codes describe gland excision, but 42450 is for the sublingual gland; this code is for the submandibular gland.

Codes related to 42440

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