Billing code 42330: Salivary stone removalMedicare rate & RVUs in Georgia
Reports intraoral incision and removal of a calculus from a sublingual or submandibular salivary duct when the stone requires surgical extraction.
Medicare pays $223.37–$242.70 for 42330 in the office in Georgia, from Rest Of Georgia to Atlanta. Which amount applies depends on the service address.
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 42330 covers
An otolaryngologist or oral and maxillofacial surgeon uses an incision inside the mouth to reach and extract a salivary calculus in the sublingual or submandibular duct region. A typical clinical situation is an obstructing duct stone causing meal-related gland swelling or recurrent symptoms when the stone cannot be removed by simpler means. The code distinguishes this intraoral approach from extraoral removal and from procedures directed at a parotid stone.
Select the code based on the documented stone site and surgical approach. The operative note should identify the affected duct or gland, the calculus, and the intraoral incision and extraction performed. Related postoperative visits during the 10-day global period are included. 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 multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are 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.
Where 42330 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $242.70 | $153.79 |
| Rest Of Georgia | $223.37 | $145.31 |
How the 42330 rate is calculated
Each of 42330’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 · 42330
RVUs × geographic indexes × conversion factor
Work2.20
2.20 RVUs× 1.000 GPCI
Practice expense4.59
4.59 RVUs× 1.000 GPCI
Malpractice0.33
0.33 RVUs× 1.000 GPCI
Adjusted RVUs
7.1200
Conversion factor
$33.4009
Medicare rate
$237.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42330
42330 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42330
Salivary stone removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 42330
Salivary stone removal
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42330 without 51 · national office
$237.81
Salivary stone removal
42330-51 · Second procedure: 50%
$118.91
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
42330 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 42335Stone removal
- Both address sublingual or submandibular calculi, but 42330 is the intraoral approach and 42335 is the extraoral approach.
- 42340Stone removal
- Use 42340 for a parotid calculus removed extraorally; 42330 is for an intraoral procedure in the sublingual or submandibular region.
- 42310Salivary drainage
- 42310 describes drainage of a sublingual or submandibular abscess through an intraoral approach. Use 42330 when the procedure removes a calculus rather than draining an abscess.
- 42320Abscess drainage
- 42320 describes extraoral drainage of a sublingual or submandibular abscess; it is not the code for intraoral calculus extraction.
42330 billing questions
How does this differ from 42335?
This code describes an intraoral approach for a sublingual or submandibular calculus. Code 42335 is the extraoral approach for those gland regions.
When is 42340 more appropriate?
42340 is used for removal of a parotid calculus by an extraoral approach. Choose based on the documented gland and surgical route.
Can modifier 50 be reported for bilateral stones?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
Are postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery is not paid, and co-surgeons and team surgery are 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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