$92.08
This code is for removal of the submandibular gland; 42400 describes needle biopsy of salivary gland tissue.
On this page
CMS RVU26D · Effective 2026-10-01
42440 Salivary gland excision Medicare reimbursement rates in Arizona
Removal of a submandibular gland, commonly for persistent obstruction, chronic inflammation, or a gland lesion, is reported with this code. Compare 42440 office and facility rates across CMS payment localities in Arizona.
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 42440 in Arizona?
Arizona 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
No supported rate
Facility setting
$361.78
1 of 1 localities have a supported rate.
Payment area: Arizona
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.
Otolaryngology surgery
About 42440: Submandibular gland excision
Removal of a submandibular gland, commonly for persistent obstruction, chronic inflammation, or a gland lesion, is reported with this code.
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.
CMS billing rules for 42440
- 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 RVU5.99 · 54%
- Practice expense (office) RVU4.21 · 38%
- Malpractice RVU0.89 · 8%
1.7K
Medicare services in 2024 · #2574 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.
42440 compared with similar codes
Office rates for Arizona, from the same CMS release.
$299.08
Use this code for gland excision. Code 42405 describes incisional biopsy rather than removal of the gland.
$554.73
Code 42408 describes excision of a salivary cyst. Choose this code when the submandibular gland itself is removed.
$459.62
Both codes describe gland excision, but 42450 is for the sublingual gland; this code is for the submandibular gland.
Compare 42440 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
Arizona →
Office / nonfacility
Unavailable
Facility
$361.78
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 42440 in Arizona.
PPRRVU2026_Oct_nonQPP.csv
5,038
- Code
- 42440
- Physician work
- 5.99
- Practice expense
- 4.21
- Malpractice
- 0.89
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.99 | × 1.000 | 5.9900 |
| Practice expense | 4.21 | × 0.969 | 4.0795 |
| Malpractice | 0.89 | × 0.856 | 0.7618 |
| Total RVUs | 10.8313 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arizona$361.78
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.99 | 1 |
| Practice expense | 4.21 | 0.969 |
| Malpractice | 0.89 | 0.856 |
(5.99 × 1 + 4.21 × 0.969 + 0.89 × 0.856) × $33.4009 = $361.78
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.
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 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.
5,03542425,,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
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
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
901112,CA,55,CHICO,1.017,1.096,0.536