FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

42665 in Austin

Office / nonfacility

$382.81

Base rate per service

Facility setting

$201.88

Base rate per service

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.

Salivary gland surgery

About 42665: Salivary duct ligation

Reports operative ligation of a salivary duct, such as when a surgeon intentionally interrupts salivary flow for a selected clinical indication.

The surgeon exposes and ties off a salivary duct to interrupt flow from the associated gland. This may be considered for selected patients with troublesome drooling or persistent salivary leakage. Otolaryngologists, oral and maxillofacial surgeons, and head and neck surgeons typically perform the operation in a surgical setting. The operative note should identify the duct and gland treated, the reason for ligation, and the technique used.

Report 42665 when the procedure actually ligates the duct; dilation of a narrowed duct and direct closure of a salivary fistula are different services. 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. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

CMS billing rules for 42665

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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.56 · 23%
  • Practice expense (office) RVU8.09 · 73%
  • Malpractice RVU0.38 · 3%

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.

42665 compared with similar codes

Office rates for Austin, from the same CMS release.

42600

Fistula closure

Salivary tract

$557.67

42600 is for direct closure of a salivary fistula. Use 42665 when the surgeon ligates a duct to interrupt salivary flow.

42650

Salivary duct dilation

Percutaneous approach

$79.24

42650 describes dilation of a salivary duct. It is not the code for tying off the duct.

42660

Salivary duct dilation

Complicated procedure

$105.16

42660 is also a salivary duct dilation service. Select 42665 when the operative service is duct ligation rather than dilation.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 42665 is $343.19—$39.62 lower than the $382.81 rate in Austin. Both use the same code, release and participation basis.

42665 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $382.81

  2. Beaumont

    $343.19

    $39.62 lower than Austin

  3. Brazoria

    $363.87

    $18.94 lower than Austin

  4. Dallas

    $366.30

    $16.51 lower than Austin

  5. Fort Worth

    $363.76

    $19.05 lower than Austin

  6. Galveston

    $365.02

    $17.79 lower than Austin

  7. Houston

    $371.98

    $10.83 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 42665 ranges from $324.16 in Arkansas to $491.36 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 42665

    Office

    $353.40

    Facility

    $191.11

    $29.41 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 42665

    Office

    $417.10

    Facility

    $214.79

    $34.29 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 42665

    Office

    $422.56

    Facility

    $221.11

    $39.75 higher than Austin for the office setting.

  • Miami

    Florida · 42665

    Office

    $398.90

    Facility

    $220.87

    $16.09 higher than Austin for the office setting.

  • Chicago

    Illinois · 42665

    Office

    $386.80

    Facility

    $214.93

    $3.99 higher than Austin for the office setting.

  • Manhattan

    New York · 42665

    Office

    $425.10

    Facility

    $226.38

    $42.29 higher than Austin for the office setting.

  • Alaska*

    Alaska · 42665

    Office

    $423.03

    Facility

    $240.90

    $40.22 higher than Austin for the office setting.

  • Alabama

    Alabama · 42665

    Office

    $329.13

    Facility

    $179.49

    $53.68 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 42665

    Office

    $324.16

    Facility

    $177.26

    $58.65 lower than Austin for the office setting.

  • Arizona

    Arizona · 42665

    Office

    $358.21

    Facility

    $192.50

    $24.60 lower than Austin for the office setting.

  • Bakersfield

    California · 42665

    Office

    $391.01

    Facility

    $203.58

    $8.20 higher than Austin for the office setting.

  • Chico

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • El Centro

    California · 42665

    Office

    $389.98

    Facility

    $202.55

    $7.17 higher than Austin for the office setting.

  • Fresno

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Madera

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Merced

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Modesto

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Napa

    California · 42665

    Office

    $453.48

    Facility

    $228.09

    $70.67 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 42665

    Office

    $415.20

    Facility

    $213.06

    $32.39 higher than Austin for the office setting.

  • Redding

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Rest Of California

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 42665

    Office

    $394.03

    Facility

    $206.60

    $11.22 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 42665

    Office

    $409.65

    Facility

    $210.76

    $26.84 higher than Austin for the office setting.

  • Salinas

    California · 42665

    Office

    $408.14

    Facility

    $209.93

    $25.33 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 42665

    Office

    $418.13

    Facility

    $213.59

    $35.32 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 42665

    Office

    $480.46

    Facility

    $239.33

    $97.65 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 42665

    Office

    $480.02

    Facility

    $238.90

    $97.21 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 42665

    Office

    $491.36

    Facility

    $244.76

    $108.55 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 42665

    Office

    $489.60

    Facility

    $243.00

    $106.79 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 42665

    Office

    $401.54

    Facility

    $206.75

    $18.73 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 42665

    Office

    $422.41

    Facility

    $214.63

    $39.60 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 42665

    Office

    $409.77

    Facility

    $210.37

    $26.96 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 42665

    Office

    $426.70

    Facility

    $216.69

    $43.89 higher than Austin for the office setting.

  • Stockton

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Vallejo

    California · 42665

    Office

    $452.86

    Facility

    $227.47

    $70.05 higher than Austin for the office setting.

  • Visalia

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Yuba City

    California · 42665

    Office

    $389.92

    Facility

    $202.49

    $7.11 higher than Austin for the office setting.

  • Colorado

    Colorado · 42665

    Office

    $383.95

    Facility

    $201.99

    $1.14 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 42665

    Office

    $393.59

    Facility

    $209.41

    $10.78 higher than Austin for the office setting.

  • Delaware

    Delaware · 42665

    Office

    $364.31

    Facility

    $195.35

    $18.50 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 42665

    Office

    $382.18

    Facility

    $208.94

    $0.63 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 42665

    Office

    $362.91

    Facility

    $199.42

    $19.90 lower than Austin for the office setting.

  • Atlanta

    Georgia · 42665

    Office

    $375.54

    Facility

    $201.79

    $7.27 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 42665

    Office

    $341.67

    Facility

    $189.12

    $41.14 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 42665

    Office

    $400.09

    Facility

    $205.65

    $17.28 higher than Austin for the office setting.

  • Iowa

    Iowa · 42665

    Office

    $337.79

    Facility

    $181.31

    $45.02 lower than Austin for the office setting.

  • Idaho

    Idaho · 42665

    Office

    $340.11

    Facility

    $182.77

    $42.70 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 42665

    Office

    $359.66

    Facility

    $202.33

    $23.15 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 42665

    Office

    $352.05

    Facility

    $195.91

    $30.76 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 42665

    Office

    $386.10

    Facility

    $210.47

    $3.29 higher than Austin for the office setting.

  • Indiana

    Indiana · 42665

    Office

    $342.16

    Facility

    $183.63

    $40.65 lower than Austin for the office setting.

  • Kansas

    Kansas · 42665

    Office

    $336.18

    Facility

    $181.58

    $46.63 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 42665

    Office

    $337.34

    Facility

    $185.31

    $45.47 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 42665

    Office

    $354.20

    Facility

    $193.27

    $28.61 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 42665

    Office

    $336.80

    Facility

    $185.46

    $46.01 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 42665

    Office

    $422.94

    Facility

    $218.75

    $40.13 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 42665

    Office

    $381.52

    Facility

    $201.45

    $1.29 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 42665

    Office

    $392.51

    Facility

    $209.02

    $9.70 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 42665

    Office

    $371.47

    Facility

    $198.40

    $11.34 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 42665

    Office

    $342.00

    Facility

    $184.67

    $40.81 lower than Austin for the office setting.

  • Southern Maine

    Maine · 42665

    Office

    $361.30

    Facility

    $191.82

    $21.51 lower than Austin for the office setting.

  • Detroit

    Michigan · 42665

    Office

    $367.66

    Facility

    $202.63

    $15.15 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 42665

    Office

    $346.54

    Facility

    $190.41

    $36.27 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 42665

    Office

    $367.31

    Facility

    $191.34

    $15.50 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 42665

    Office

    $351.64

    Facility

    $191.06

    $31.17 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 42665

    Office

    $355.47

    Facility

    $192.66

    $27.34 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 42665

    Office

    $330.79

    Facility

    $183.38

    $52.02 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 42665

    Office

    $327.54

    Facility

    $180.30

    $55.27 lower than Austin for the office setting.

  • Montana**

    Montana · 42665

    Office

    $368.39

    Facility

    $197.37

    $14.42 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 42665

    Office

    $345.73

    Facility

    $186.17

    $37.08 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 42665

    Office

    $360.87

    Facility

    $189.86

    $21.94 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 42665

    Office

    $339.71

    Facility

    $181.87

    $43.10 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 42665

    Office

    $377.90

    Facility

    $199.88

    $4.91 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 42665

    Office

    $417.90

    Facility

    $219.52

    $35.09 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 42665

    Office

    $397.92

    Facility

    $211.18

    $15.11 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 42665

    Office

    $348.54

    Facility

    $191.72

    $34.27 lower than Austin for the office setting.

  • Nevada**

    Nevada · 42665

    Office

    $366.56

    Facility

    $195.38

    $16.25 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 42665

    Office

    $435.83

    Facility

    $232.50

    $53.02 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 42665

    Office

    $400.60

    Facility

    $213.34

    $17.79 higher than Austin for the office setting.

  • Queens

    New York · 42665

    Office

    $428.67

    Facility

    $226.54

    $45.86 higher than Austin for the office setting.

  • Rest Of New York

    New York · 42665

    Office

    $351.13

    Facility

    $188.67

    $31.68 lower than Austin for the office setting.

  • Ohio

    Ohio · 42665

    Office

    $345.00

    Facility

    $188.87

    $37.81 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 42665

    Office

    $336.67

    Facility

    $183.95

    $46.14 lower than Austin for the office setting.

  • Portland

    Oregon · 42665

    Office

    $396.52

    Facility

    $206.53

    $13.71 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 42665

    Office

    $363.56

    Facility

    $193.23

    $19.25 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 42665

    Office

    $383.48

    Facility

    $205.46

    $0.67 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 42665

    Office

    $345.56

    Facility

    $188.57

    $37.25 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 42665

    Office

    $371.19

    Facility

    $198.30

    $11.62 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 42665

    Office

    $377.58

    Facility

    $200.93

    $5.23 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 42665

    Office

    $345.97

    Facility

    $187.96

    $36.84 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 42665

    Office

    $359.98

    Facility

    $188.97

    $22.83 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 42665

    Office

    $337.95

    Facility

    $182.50

    $44.86 lower than Austin for the office setting.

  • Utah

    Utah · 42665

    Office

    $350.90

    Facility

    $190.15

    $31.91 lower than Austin for the office setting.

  • Virginia

    Virginia · 42665

    Office

    $360.09

    Facility

    $191.98

    $22.72 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 42665

    Office

    $371.19

    Facility

    $198.30

    $11.62 lower than Austin for the office setting.

  • Vermont

    Vermont · 42665

    Office

    $359.44

    Facility

    $190.14

    $23.37 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 42665

    Office

    $380.81

    Facility

    $200.74

    $2.00 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 42665

    Office

    $431.70

    Facility

    $221.87

    $48.89 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 42665

    Office

    $348.28

    Facility

    $184.45

    $34.53 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 42665

    Office

    $338.48

    Facility

    $189.87

    $44.33 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 42665

    Office

    $365.11

    Facility

    $194.10

    $17.70 lower than Austin for the office setting.

See how rates vary across the country

42665 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$324.16

$440.64

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$423.031
AL$329.131
AR$324.161
AZ$358.211
CA$389.92–$491.3629
CO$383.951
CT$393.591
DC$422.561
DE$364.311
FL$362.91–$398.903
GA$341.67–$375.542
GU$400.091
HI$400.091
IA$337.791
ID$340.111
IL$352.05–$386.804
IN$342.161
KS$336.181
KY$337.341
LA$336.80–$354.202
MA$381.52–$422.942
MD$371.47–$422.563
ME$342.00–$361.302
MI$346.54–$367.662
MN$367.311
MO$330.79–$355.473
MS$327.541
MT$368.391
NC$345.731
ND$360.871
NE$339.711
NH$377.901
NJ$397.92–$417.902
NM$348.541
NV$366.561
NY$351.13–$435.835
OH$345.001
OK$336.671
OR$363.56–$396.522
PA$345.56–$383.482
PR$371.191
RI$377.581
SC$345.971
SD$359.981
TN$337.951
TX$343.19–$382.818
UT$350.901
VA$360.09–$422.562
VI$371.191
VT$359.441
WA$380.81–$431.702
WI$348.281
WV$338.481
WY$365.111

Explore 42665 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 42665 in Austin, the physician’s office rate is $382.81 and the facility-setting rate is $201.88: a difference of $180.93.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 42665 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$421.09

$382.81 × 110% = $421.09

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 42665 in Austin.

PPRRVU2026_Oct_nonQPP.csv

5,057

Code
42665
Physician work
2.56
Practice expense
8.09
Malpractice
0.38

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 42665 in Austin
ComponentRVULocality factorAdjusted
Physician work2.56× 1.0022.5651
Practice expense8.09× 1.0588.5592
Malpractice0.38× 0.8860.3367
Total RVUs11.4610
Conversion factor× 33.4009

Office / nonfacility rate, Austin$382.81

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 42665 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.561.002
Practice expense8.091.058
Malpractice0.380.886

(2.56 × 1.002 + 8.09 × 1.058 + 0.38 × 0.886) × $33.4009 = $382.81

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.561.002
Practice expense2.971.058
Malpractice0.380.886

(2.56 × 1.002 + 2.97 × 1.058 + 0.38 × 0.886) × $33.4009 = $201.88

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

42665 · Office / nonfacility

$382.81

Effective 2026-10-01

The base rate is $9.44 higher than on 2025-10-01, moving from $373.37 to $382.81 (2.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $373.37changed to$382.81

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.63 changed to 2.56
    • Practice expense RVU 8.18 changed to 8.09
    • Malpractice RVU 0.39 changed to 0.38
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $373.37

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$382.81$201.88RVU26D
2026-07-01$382.81$201.88RVU26C
2026-04-01$382.81$201.88RVU26B
2026-01-01$382.81$201.88RVU26A
2025-10-01$373.37$219.76RVU25D
2025-07-01$373.37$219.76RVU25C
2025-04-01$373.37$219.76RVU25B
2025-01-01$373.37$219.76RVU25A

42665 billing questions

How is duct ligation different from salivary duct dilation?

Ligation intentionally interrupts salivary flow. Dilation opens a narrowed duct to restore or improve flow.

Is ligation the same as closing a salivary fistula?

No. Ligation ties off a duct, while fistula closure directly repairs the abnormal communication. Report the procedure actually performed.

What documentation supports 42665?

The operative note should identify the duct and gland, the clinical reason for interruption, and the ligation performed.

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

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

Can an assistant surgeon be reported?

Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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.

RVUs for 42665PPRRVU2026_Oct_nonQPP.csv, line 5,057 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet