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 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$723.37
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.
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 rates for Delaware, 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.
The same code, a different location
How does Delaware compare?
42425 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
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
Alabama
Alabama · 42425
Office
Unavailable
Facility
$673.76
No comparable office rate is available.
Arkansas
Arkansas · 42425
Office
Unavailable
Facility
$666.79
No comparable office rate is available.
Arizona
Arizona · 42425
Office
Unavailable
Facility
$714.05
No comparable office rate is available.
Bakersfield
California · 42425
Office
Unavailable
Facility
$735.41
No comparable office rate is available.
Chico
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
El Centro
California · 42425
Office
Unavailable
Facility
$730.13
No comparable office rate is available.
Fresno
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Hanford-Corcoran
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Madera
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Merced
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Modesto
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Napa
California · 42425
Office
Unavailable
Facility
$798.88
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 42425
Office
Unavailable
Facility
$759.92
No comparable office rate is available.
Redding
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Rest Of California
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 42425
Office
Unavailable
Facility
$750.78
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 42425
Office
Unavailable
Facility
$753.43
No comparable office rate is available.
Salinas
California · 42425
Office
Unavailable
Facility
$750.33
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 42425
Office
Unavailable
Facility
$758.75
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 42425
Office
Unavailable
Facility
$830.73
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 42425
Office
Unavailable
Facility
$828.53
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 42425
Office
Unavailable
Facility
$849.60
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 42425
Office
Unavailable
Facility
$840.59
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 42425
Office
Unavailable
Facility
$739.64
No comparable office rate is available.
Santa Cruz-Watsonville
California · 42425
Office
Unavailable
Facility
$758.78
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 42425
Office
Unavailable
Facility
$750.62
No comparable office rate is available.
Santa Rosa-Petaluma
California · 42425
Office
Unavailable
Facility
$765.68
No comparable office rate is available.
Stockton
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Vallejo
California · 42425
Office
Unavailable
Facility
$795.70
No comparable office rate is available.
Visalia
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Yuba City
California · 42425
Office
Unavailable
Facility
$729.80
No comparable office rate is available.
Colorado
Colorado · 42425
Office
Unavailable
Facility
$736.17
No comparable office rate is available.
Connecticut
Connecticut · 42425
Office
Unavailable
Facility
$770.44
No comparable office rate is available.
Fort Lauderdale
Florida · 42425
Office
Unavailable
Facility
$785.81
No comparable office rate is available.
Rest Of Florida
Florida · 42425
Office
Unavailable
Facility
$753.00
No comparable office rate is available.
Atlanta
Georgia · 42425
Office
Unavailable
Facility
$748.47
No comparable office rate is available.
Rest Of Georgia
Georgia · 42425
Office
Unavailable
Facility
$718.21
No comparable office rate is available.
Hawaii, Guam
Hawaii · 42425
Office
Unavailable
Facility
$734.54
No comparable office rate is available.
Iowa
Iowa · 42425
Office
Unavailable
Facility
$671.96
No comparable office rate is available.
Idaho
Idaho · 42425
Office
Unavailable
Facility
$678.03
No comparable office rate is available.
East St. Louis
Illinois · 42425
Office
Unavailable
Facility
$777.88
No comparable office rate is available.
Rest Of Illinois
Illinois · 42425
Office
Unavailable
Facility
$747.05
No comparable office rate is available.
Suburban Chicago
Illinois · 42425
Office
Unavailable
Facility
$789.74
No comparable office rate is available.
Indiana
Indiana · 42425
Office
Unavailable
Facility
$680.47
No comparable office rate is available.
Kansas
Kansas · 42425
Office
Unavailable
Facility
$676.37
No comparable office rate is available.
Kentucky
Kentucky · 42425
Office
Unavailable
Facility
$699.57
No comparable office rate is available.
New Orleans
Louisiana · 42425
Office
Unavailable
Facility
$725.79
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 42425
Office
Unavailable
Facility
$701.44
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 42425
Office
Unavailable
Facility
$785.65
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 42425
Office
Unavailable
Facility
$736.44
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 42425
Office
Unavailable
Facility
$769.53
No comparable office rate is available.
Rest Of Maryland
Maryland · 42425
Office
Unavailable
Facility
$732.28
No comparable office rate is available.
Rest Of Maine
Maine · 42425
Office
Unavailable
Facility
$687.68
No comparable office rate is available.
Southern Maine
Maine · 42425
Office
Unavailable
Facility
$704.51
No comparable office rate is available.
Detroit
Michigan · 42425
Office
Unavailable
Facility
$766.92
No comparable office rate is available.
Rest Of Michigan
Michigan · 42425
Office
Unavailable
Facility
$718.93
No comparable office rate is available.
Minnesota
Minnesota · 42425
Office
Unavailable
Facility
$691.50
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 42425
Office
Unavailable
Facility
$715.03
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 42425
Office
Unavailable
Facility
$719.63
No comparable office rate is available.
Rest Of Missouri
Missouri · 42425
Office
Unavailable
Facility
$697.22
No comparable office rate is available.
Mississippi
Mississippi · 42425
Office
Unavailable
Facility
$681.76
No comparable office rate is available.
Montana**
Montana · 42425
Office
Unavailable
Facility
$730.35
No comparable office rate is available.
North Carolina
North Carolina · 42425
Office
Unavailable
Facility
$691.76
No comparable office rate is available.
North Dakota**
North Dakota · 42425
Office
Unavailable
Facility
$691.99
No comparable office rate is available.
Nebraska
Nebraska · 42425
Office
Unavailable
Facility
$672.56
No comparable office rate is available.
New Hampshire
New Hampshire · 42425
Office
Unavailable
Facility
$731.76
No comparable office rate is available.
Northern Nj
New Jersey · 42425
Office
Unavailable
Facility
$799.01
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 42425
Office
Unavailable
Facility
$775.29
No comparable office rate is available.
New Mexico
New Mexico · 42425
Office
Unavailable
Facility
$724.51
No comparable office rate is available.
Nevada**
Nevada · 42425
Office
Unavailable
Facility
$719.89
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 42425
Office
Unavailable
Facility
$857.21
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 42425
Office
Unavailable
Facility
$785.48
No comparable office rate is available.
Queens
New York · 42425
Office
Unavailable
Facility
$828.72
No comparable office rate is available.
Rest Of New York
New York · 42425
Office
Unavailable
Facility
$699.79
No comparable office rate is available.
Ohio
Ohio · 42425
Office
Unavailable
Facility
$711.09
No comparable office rate is available.
Oklahoma
Oklahoma · 42425
Office
Unavailable
Facility
$691.55
No comparable office rate is available.
Portland
Oregon · 42425
Office
Unavailable
Facility
$746.28
No comparable office rate is available.
Rest Of Oregon
Oregon · 42425
Office
Unavailable
Facility
$710.32
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 42425
Office
Unavailable
Facility
$760.23
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 42425
Office
Unavailable
Facility
$708.15
No comparable office rate is available.
Puerto Rico
Puerto Rico · 42425
Office
Unavailable
Facility
$732.02
No comparable office rate is available.
Rhode Island
Rhode Island · 42425
Office
Unavailable
Facility
$739.33
No comparable office rate is available.
South Carolina
South Carolina · 42425
Office
Unavailable
Facility
$703.37
No comparable office rate is available.
South Dakota**
South Dakota · 42425
Office
Unavailable
Facility
$687.45
No comparable office rate is available.
Tennessee
Tennessee · 42425
Office
Unavailable
Facility
$679.66
No comparable office rate is available.
Austin
Texas · 42425
Office
Unavailable
Facility
$737.23
No comparable office rate is available.
Beaumont
Texas · 42425
Office
Unavailable
Facility
$705.29
No comparable office rate is available.
Brazoria
Texas · 42425
Office
Unavailable
Facility
$717.66
No comparable office rate is available.
Dallas
Texas · 42425
Office
Unavailable
Facility
$724.29
No comparable office rate is available.
Fort Worth
Texas · 42425
Office
Unavailable
Facility
$722.85
No comparable office rate is available.
Galveston
Texas · 42425
Office
Unavailable
Facility
$721.23
No comparable office rate is available.
Houston
Texas · 42425
Office
Unavailable
Facility
$756.74
No comparable office rate is available.
Rest Of Texas
Texas · 42425
Office
Unavailable
Facility
$712.52
No comparable office rate is available.
Utah
Utah · 42425
Office
Unavailable
Facility
$710.14
No comparable office rate is available.
Virginia
Virginia · 42425
Office
Unavailable
Facility
$707.54
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 42425
Office
Unavailable
Facility
$732.02
No comparable office rate is available.
Vermont
Vermont · 42425
Office
Unavailable
Facility
$696.18
No comparable office rate is available.
Rest Of Washington
Washington · 42425
Office
Unavailable
Facility
$732.80
No comparable office rate is available.
Seattle (King Cnty)
Washington · 42425
Office
Unavailable
Facility
$792.40
No comparable office rate is available.
Wisconsin
Wisconsin · 42425
Office
Unavailable
Facility
$676.03
No comparable office rate is available.
West Virginia
West Virginia · 42425
Office
Unavailable
Facility
$728.43
No comparable office rate is available.
Wyoming**
Wyoming · 42425
Office
Unavailable
Facility
$713.63
No comparable office rate is available.
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 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 42425 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$795.71
$723.37 × 110% = $795.71
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.
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 42425 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
5,035
- Code
- 42425
- Physician work
- 13.08
- Practice expense
- 6.85
- Malpractice
- 1.94
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.08 | × 1.005 | 13.1454 |
| Practice expense | 6.85 | × 0.988 | 6.7678 |
| Malpractice | 1.94 | × 0.899 | 1.7441 |
| Total RVUs | 21.6573 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$723.37
Open 42425 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.08 | 1.005 |
| Practice expense | 6.85 | 0.988 |
| Malpractice | 1.94 | 0.899 |
(13.08 × 1.005 + 6.85 × 0.988 + 1.94 × 0.899) × $33.4009 = $723.37
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
42425 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $723.37 | RVU26D |
| 2026-07-01 | Not available in this setting | $723.37 | RVU26C |
| 2026-04-01 | Not available in this setting | $723.37 | RVU26B |
| 2026-01-01 | Not available in this setting | $723.37 | RVU26A |
| 2025-10-01 | Not available in this setting | $819.97 | RVU25D |
| 2025-07-01 | Not available in this setting | $819.97 | RVU25C |
| 2025-04-01 | Not available in this setting | $819.97 | RVU25B |
| 2025-01-01 | Not available in this setting | $819.97 | RVU25A |
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
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503