No office rate
Choose 42450 for the sublingual gland beneath the tongue; choose 42440 for the submaxillary, or submandibular, gland.
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CMS RVU26D · Effective 2026-10-01
42450 Gland excision Medicare reimbursement rates in Alaska
Removal of the sublingual salivary gland, commonly performed for disease involving the gland or as part of treatment for a recurrent ranula. Compare 42450 office and facility rates across CMS payment localities in Alaska.
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.
What does Medicare pay for 42450 in Alaska?
Alaska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$558.43
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
Facility setting
$406.53
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Salivary gland surgery
About 42450: Sublingual gland excision
Removal of the sublingual salivary gland, commonly performed for disease involving the gland or as part of treatment for a recurrent ranula.
This operation removes the sublingual salivary gland, which lies in the floor of the mouth beneath the tongue. An otolaryngologist or oral and maxillofacial surgeon typically performs it in a hospital or ambulatory surgical setting. The operative report should identify the sublingual gland as the structure removed and describe the reason for excision, such as gland disease or treatment of a recurrent ranula.
Report this code for removal of the sublingual gland, not for sampling a gland or treating only a discrete cyst. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 42450
- 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 RVU4.62 · 33%
- Practice expense (office) RVU8.85 · 63%
- Malpractice RVU0.66 · 5%
97
Medicare services in 2024 · #4907 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.
42450 compared with similar codes
Office rates for Alaska, from the same CMS release.
$110.34
42400 represents salivary gland biopsy. Use 42450 when the sublingual gland itself is removed rather than sampled.
$662.02
42408 is for excision of a salivary cyst. Choose 42450 when the operative target is removal of the sublingual gland.
No office rate
42410 concerns excision involving the parotid gland or a parotid lesion; 42450 concerns the sublingual gland.
Compare 42450 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alaska* →
Office / nonfacility
$558.43
Facility
$406.53
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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 42450 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
5,039
- Code
- 42450
- Physician work
- 4.62
- Practice expense
- 8.85
- Malpractice
- 0.66
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.62 | × 1.500 | 6.9300 |
| Practice expense | 8.85 | × 1.065 | 9.4252 |
| Malpractice | 0.66 | × 0.551 | 0.3637 |
| Total RVUs | 16.7189 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alaska*$558.43
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.62 | 1.5 |
| Practice expense | 8.85 | 1.065 |
| Malpractice | 0.66 | 0.551 |
(4.62 × 1.5 + 8.85 × 1.065 + 0.66 × 0.551) × $33.4009 = $558.43
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.62 | 1.5 |
| Practice expense | 4.58 | 1.065 |
| Malpractice | 0.66 | 0.551 |
(4.62 × 1.5 + 4.58 × 1.065 + 0.66 × 0.551) × $33.4009 = $406.53
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.
42450 billing questions
How does this differ from submaxillary gland excision?
This code is for removal of the sublingual gland beneath the tongue. Code 42440 is for removal of the submaxillary, or submandibular, gland.
Can this code be used for a salivary gland biopsy?
No. Use a biopsy code when tissue is sampled without removing the sublingual gland; this code represents gland excision.
Is modifier 50 appropriate when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant at surgery payable?
Only when the record documents medical necessity for the assistant. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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.
5,03642426,,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
5,03942450,,Excise sublingual gland,A,,4.62,8.85,,4.58,,0.66,14.13,9.86,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0404245F,,Pt instr nrml activities,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
5,0414248F,,Pt instr no bd rest 4 days/>,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
5,04242500,,Repair salivary duct,A,,4.31,8.51,,4.45,,0.62,13.44,9.38,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609