No office rate
Use 42507 for intraoral parotid duct diversion. Code 42510 is priced as bilateral, rather than identifying the intraoral approach.
On this page
CMS RVU26D · Effective 2026-10-01
42510 Parotid duct diversion Medicare reimbursement rates in Guam
Reports surgical rerouting of both parotid ducts, commonly to manage persistent troublesome saliva flow such as severe drooling. Compare 42510 office and facility rates across CMS payment localities in Guam.
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 42510 in Guam?
Guam 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
$551.43
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 42510: Bilateral parotid duct diversion
Reports surgical rerouting of both parotid ducts, commonly to manage persistent troublesome saliva flow such as severe drooling.
A surgeon redirects parotid duct drainage to change where saliva enters the mouth. The procedure may be considered for persistent, troublesome sialorrhea, including severe drooling associated with neurologic impairment. Otolaryngologists and oral and maxillofacial surgeons typically perform it in an operating room. This code is priced as bilateral, so it represents work on both parotid ducts rather than a separately priced unilateral service.
Report the code when documentation supports diversion of both parotid ducts; record the indication, sides treated, and operative approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 42510
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- 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 RVU8.14 · 51%
- Practice expense (office) RVU6.75 · 42%
- Malpractice RVU1.20 · 7%
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.
42510 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
Use 42509 for extraoral parotid duct diversion. Code 42510 is priced as bilateral, rather than identifying the extraoral approach.
$479.13
Code 42500 describes simple salivary duct repair. Choose diversion when the operation reroutes parotid drainage instead of repairing the duct.
$607.86
Code 42505 describes complicated salivary duct repair; 42510 is for parotid duct diversion, not restoration of a damaged duct.
Compare 42510 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$551.43
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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 42510 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,047
- Code
- 42510
- Physician work
- 8.14
- Practice expense
- 6.75
- Malpractice
- 1.20
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.14 | × 1.000 | 8.1400 |
| Practice expense | 6.75 | × 1.137 | 7.6748 |
| Malpractice | 1.20 | × 0.579 | 0.6948 |
| Total RVUs | 16.5096 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$551.43
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.14 | 1 |
| Practice expense | 6.75 | 1.137 |
| Malpractice | 1.2 | 0.579 |
(8.14 × 1 + 6.75 × 1.137 + 1.2 × 0.579) × $33.4009 = $551.43
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.
42510 billing questions
How does this differ from codes 42507 and 42509?
Those codes distinguish intraoral and extraoral parotid duct diversion. Code 42510 is priced as bilateral; use the code that matches the documented procedure and approach.
Should modifier 50 be appended?
No. CMS pricing for this code already treats it as bilateral, and modifier 50 does not increase payment.
Are related postoperative visits separately reported?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What documentation supports the code?
Document the clinical reason for diversion, that both parotid ducts were treated, and the operative approach and work performed.
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.
5,04442507,,Parotid duct diversion,A,,6.09,6.24,NA,6.24,,0.89,13.22,13.22,0,090,0.09,0.81,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,04542509,,Parotid duct diversion,A,,11.47,8.38,NA,8.38,,1.67,21.52,21.52,0,090,0.09,0.81,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0464250F,,Wrmng 4 surg normothermia,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
5,04742510,,Parotid duct diversion,A,,8.14,6.75,NA,6.75,,1.20,16.09,16.09,0,090,0.09,0.81,0.10,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,04842550,,Injection for salivary x-ray,A,,1.22,3.06,,0.22,,0.12,4.40,1.56,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0494255F,,Anesth 60 min/> as docd,M,,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
5,0504256F,,Anesthe <60 min as docd,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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014