Billing code 42440: Salivary gland excisionMedicare rate & RVUs in Alaska
Removal of a submandibular gland, commonly for persistent obstruction, chronic inflammation, or a gland lesion, is reported with this code.
CMS doesn’t publish an office rate for 42440 in Alaska.
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 9 sections
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.
42440 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $466.24 |
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.
How the rate is built · 42440
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.99Practice expense 4.21Malpractice 0.89
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 42440
42440 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42440
Salivary gland excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 42440
Salivary gland excision
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
42440 without 50 · national facility
$370.42
Salivary gland excision
42440-50 · Bilateral: 150%
$555.63
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
42440 compared with similar codes
Compare codes
42440 vs 42400 vs 42405 vs 42408 vs 42450: national Medicare rates
Swap in your local Medicare rate.
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.
42440 billing questions
When is this code appropriate instead of a salivary gland biopsy code?
Use this code when the submandibular gland is surgically removed. A biopsy code describes diagnostic tissue sampling, not removal of the gland.
Does sending the excised gland to pathology support a separate biopsy charge?
No. The tissue produced by gland excision is not a separate biopsy service merely because it is submitted for pathology.
How should bilateral gland removal be reported?
For removal of both submandibular glands, report the bilateral service with modifier 50. CMS lists payment at 150% for bilateral reporting.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 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
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