No office rate
Choose 42426 when total parotidectomy with facial nerve dissection and preservation is performed with a unilateral radical neck dissection. Choose 42425 for the parotid operation without that neck dissection.
On this page
CMS RVU26D · Effective 2026-10-01
42426 Parotidectomy Medicare reimbursement rates in Hawaii
Total parotid removal with facial nerve dissection and unilateral radical neck dissection for cases requiring this combined operation. Compare 42426 office and facility rates across CMS payment localities in Hawaii.
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 42426 in Hawaii?
Hawaii 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
$1159.83
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.
Head and neck surgery
About 42426: Total parotidectomy with radical neck dissection
Total parotid removal with facial nerve dissection and unilateral radical neck dissection for cases requiring this combined operation.
This operation removes the entire parotid gland and includes dissection and preservation of the facial nerve together with a unilateral radical neck dissection. It is typically performed by an otolaryngologist or head-and-neck surgeon in a hospital operating room for extensive parotid disease requiring treatment of cervical nodes. The operative report should establish the gland removal, nerve dissection and preservation, and neck dissection performed.
Report 42426 when the documented operation includes all of these elements, rather than a parotidectomy alone or a limited-lobe excision. The record should identify the side, extent of gland resection, facial nerve management, and extent of the neck dissection. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is paid at 150% for bilateral performance. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 42426
- 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 RVU22.09 · 63%
- Practice expense (office) RVU9.34 · 27%
- Malpractice RVU3.48 · 10%
175
Medicare services in 2024 · #4443 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.
42426 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
42420 describes total parotidectomy without facial nerve dissection and preservation. 42426 includes nerve dissection and preservation plus a unilateral radical neck dissection.
No office rate
42415 is for lateral-lobe parotid excision with facial nerve dissection and preservation. 42426 involves removal of the total parotid gland and a unilateral radical neck dissection.
Compare 42426 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
$1159.83
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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 42426 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,036
- Code
- 42426
- Physician work
- 22.09
- Practice expense
- 9.34
- Malpractice
- 3.48
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.09 | × 1.000 | 22.0900 |
| Practice expense | 9.34 | × 1.137 | 10.6196 |
| Malpractice | 3.48 | × 0.579 | 2.0149 |
| Total RVUs | 34.7245 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1159.83
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.09 | 1 |
| Practice expense | 9.34 | 1.137 |
| Malpractice | 3.48 | 0.579 |
(22.09 × 1 + 9.34 × 1.137 + 3.48 × 0.579) × $33.4009 = $1159.83
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.
42426 billing questions
How does 42426 differ from 42425?
42426 includes a unilateral radical neck dissection with total parotid removal and facial nerve dissection and preservation. Use 42425 when the documented total parotidectomy does not include that neck dissection.
Can the radical neck dissection be reported separately?
The neck dissection is part of the combined operation represented by 42426. Do not separately report the same neck dissection as an additional procedure.
What documentation supports 42426?
Document total parotid removal, facial nerve dissection and preservation, and the unilateral radical neck dissection. Identify the operative side and the extent of each component.
How is bilateral performance reported?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150% when performed bilaterally.
What global period applies?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. 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.
5,03342415,,Excise parotid gland/lesion,A,,16.73,8.31,NA,8.31,,2.51,27.55,27.55,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03442420,,Excise parotid gland/lesion,A,,19.04,8.84,NA,8.84,,2.83,30.71,30.71,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03542425,,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
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