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CPT 42507: Parotid duct diversionMedicare rate & RVUs

Reports bilateral redirection of parotid saliva, typically as surgery to manage severe drooling when the operative plan diverts both parotid ducts.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $441.56 for 42507 nationally in a facility.

Medicare rate · 42507

Parotid duct diversion

Swap in your local Medicare rate.

Work RVUs
6.09
Total RVUs
13.22
Global days
090

National rate · 2026

$441.56

Facility setting, before claim adjustments.

See every locality for 42507 →

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 42507 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 42507 covers

This operation redirects saliva from both parotid ducts, which carry saliva from the parotid glands into the mouth. Otolaryngologists and other surgeons who treat salivary-duct disorders may perform it, including in patients with severe drooling for whom the treatment plan redirects salivary flow. The operative report should identify the ducts treated and describe the diversion performed; a repair that restores a damaged duct is a different service.

Report this code when the documented operation includes bilateral parotid duct diversion. CMS prices the code as bilateral, so modifier 50 does not increase payment. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 50% multiple-procedure reduction. Assistant-at-surgery payment may be allowed; 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 42507 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

42507 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$402.61
Alaska*Unavailable$543.47
ArizonaUnavailable$430.82
ArkansasUnavailable$397.75
AtlantaUnavailable$451.48
AustinUnavailable$450.67
BakersfieldUnavailable$453.81
Baltimore/Surr. CntysUnavailable$467.07
BeaumontUnavailable$420.69
BrazoriaUnavailable$434.77

42507 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
42507 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 42507 rate is calculated

Each of 42507’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 · 42507

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.09Practice expense 6.24Malpractice 0.89

13.2200 adjusted RVUs×$33.4009 conversion factor=$441.56

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

Payment rules and modifiers for 42507

42507 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 42507

Parotid duct diversion

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)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
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 · 42507

Parotid duct diversion

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 51 · payment effect

With and without the modifier

42507 without 51 · national facility

$441.56

Parotid duct diversion

42507-51 · Second procedure: 50%

$220.78

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

42507 compared with similar codes

Compare codes

42507 vs 42500 vs 42505 vs 42509 vs 42510: national Medicare rates

Swap in your local Medicare rate.

  • 42507
    Parotid duct diversion · 6.09 wRVU
    —
  • 42500
    Duct repair · 4.31 wRVU
    $448.91
  • 42505
    Salivary duct repair · 6.16 wRVU
    $574.16
  • 42509
    Parotid duct diversion · 11.47 wRVU
    —
  • 42510
    Parotid duct diversion · 8.14 wRVU
    —

How to choose

42500Duct repair
42500 is for simple repair of a salivary duct. Choose 42507 when the surgeon diverts both parotid ducts rather than repairing a duct.
42505Salivary duct repair
42505 is for complicated salivary duct repair. It does not describe redirecting both parotid ducts.
42509Parotid duct diversion
Both codes concern parotid duct diversion. Compare the code descriptor with the operative report's documented procedure and laterality before selecting the code.
42510Parotid duct diversion
This is another parotid duct diversion option. Select between the family codes using the operative details and the distinctions in their descriptors.

Codes related to 42507

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

Codes related to 42507
CodeHow it relatesNational office range
Same family
42509Parotid duct diversionA related parotid duct diversion option; use the documented operation and applicable descriptor to distinguish it.No office rate
42510Parotid duct diversionAnother parotid duct diversion code in the same family; compare the operative details with its descriptor.No office rate
Used instead
42500Duct repairFor simple salivary duct repair rather than diversion of both parotid ducts.$398.79–$580.77
42505Salivary duct repairFor complicated salivary duct repair rather than diversion of both parotid ducts.$511.87–$732.40

42507 billing questions

When should this code be selected instead of a parotid duct repair code?

Use this code for documented diversion of both parotid ducts. Codes 42500 and 42505 describe duct repair, not intentional redirection of salivary flow.

Should modifier 50 be appended?

No. CMS prices this code as bilateral, and modifier 50 does not increase payment.

What documentation supports reporting the bilateral service?

The operative report should identify treatment of both parotid ducts and describe the diversion performed. Documentation of only one duct does not support the bilateral service.

How does the 90-day global period affect postoperative reporting?

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

Can another procedure performed in the same session be separately paid?

Other procedures may be reported when independently supported, but CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full and others at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be allowed. Co-surgeons and team surgery are not permitted for this code.

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 42507PPRRVU2026_Oct_nonQPP.csv, line 5,044 (RVU26D)

Open CMS sourceHow we calculate rates

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