FeeBase
Log inGet started
Menu

Billing code 42510: Parotid duct diversionMedicare rate & RVUs

Reports surgical rerouting of both parotid ducts, commonly to manage persistent troublesome saliva flow such as severe drooling.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $537.42 for 42510 nationally in a facility.

Medicare rate · 42510

Parotid duct diversion

Swap in your local Medicare rate.

Work RVUs
8.14
Total RVUs
16.09
Global days
090

National rate · 2026

$537.42

Facility setting, before claim adjustments.

See every locality for 42510 → · 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 42510 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 42510 covers

A surgeon redirects parotid duct drainage to change where saliva enters the mouth. The procedure may be considered for persistent, troublesome sialorrhea, including severe drooling associated with neurologic impairment. Otolaryngologists and oral and maxillofacial surgeons typically perform it in an operating room. This code is priced as bilateral, so it represents work on both parotid ducts rather than a separately priced unilateral service.

Report the code when documentation supports diversion of both parotid ducts; record the indication, sides treated, and operative approach. CMS assigns 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 multiple procedure reduction. Assistant-at-surgery services may be paid; 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 42510 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

42510 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$491.84
Alaska*Unavailable$670.02
ArizonaUnavailable$524.66
ArkansasUnavailable$486.19
AtlantaUnavailable$549.90
AustinUnavailable$546.47
BakersfieldUnavailable$548.56
Baltimore/Surr. CntysUnavailable$567.73
BeaumontUnavailable$514.28
BrazoriaUnavailable$528.75

42510 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 every state and territory as a table
42510 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 42510 rate is calculated

Each of 42510’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 · 42510

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.14Practice expense 6.75Malpractice 1.20

16.0900 adjusted RVUs×$33.4009 conversion factor=$537.42

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

Payment rules and modifiers for 42510

42510 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 42510

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)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 · 42510

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

42510 without 51 · national facility

$537.42

Parotid duct diversion

42510-51 · Second procedure: 50%

$268.71

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

42510 compared with similar codes

Compare codes

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

Swap in your local Medicare rate.

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

How to choose

42507Parotid duct diversion
Use 42507 for intraoral parotid duct diversion. Code 42510 is priced as bilateral, rather than identifying the intraoral approach.
42509Parotid duct diversion
Use 42509 for extraoral parotid duct diversion. Code 42510 is priced as bilateral, rather than identifying the extraoral approach.
42500Duct repair
Code 42500 describes simple salivary duct repair. Choose diversion when the operation reroutes parotid drainage instead of repairing the duct.
42505Salivary duct repair
Code 42505 describes complicated salivary duct repair; 42510 is for parotid duct diversion, not restoration of a damaged duct.

Codes related to 42510

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

Codes related to 42510
CodeHow it relatesNational office range
Same family
42507Parotid duct diversionParotid duct diversion distinguished by an intraoral approach.No office rate
42509Parotid duct diversionParotid duct diversion distinguished by an extraoral approach.No office rate
Used instead
42500Duct repairSimple salivary duct repair restores a duct rather than diverting parotid drainage.$398.79–$580.77
42505Salivary duct repairComplicated salivary duct repair addresses restoration rather than parotid duct diversion.$511.87–$732.40

42510 billing questions

How does this differ from codes 42507 and 42509?

Those codes distinguish intraoral and extraoral parotid duct diversion. Code 42510 is priced as bilateral; use the code that matches the documented procedure and approach.

Should modifier 50 be appended?

No. CMS pricing for this code already treats it as bilateral, and modifier 50 does not increase payment.

Are related postoperative visits separately reported?

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

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard multiple procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What documentation supports the code?

Document the clinical reason for diversion, that both parotid ducts were treated, and the operative approach and work 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

Show the CMS file lines behind this rate
RVUs for 42510PPRRVU2026_Oct_nonQPP.csv, line 5,047 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 42510 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 42510 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →