No office rate
Both involve total parotid excision. Choose 42425 when the facial nerve is sacrificed; choose 42420 when it is dissected and preserved.
On this page
CMS RVU26D · Effective 2026-10-01
42425 Parotidectomy Medicare reimbursement rates in Kansas
Reports complete removal of a parotid gland and tumor with facial nerve sacrifice, typically when the tumor involves the nerve. Compare 42425 office and facility rates across CMS payment localities in Kansas.
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 42425 in Kansas?
Kansas 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
$676.37
1 of 1 localities have a supported rate.
Payment area: Kansas
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 42425: Total parotidectomy with facial nerve sacrifice
Reports complete removal of a parotid gland and tumor with facial nerve sacrifice, typically when the tumor involves the nerve.
This operation removes the entire parotid gland and tumor while sacrificing the facial nerve, typically because the tumor involves or encases the nerve. An otolaryngologist or head-and-neck surgeon performs it in an operating room, often for an extensive parotid neoplasm. Sacrificing the nerve can cause facial weakness or paralysis on the operated side.
Report this code when the operative report supports total gland excision and facial nerve sacrifice; lateral-lobe removal or nerve preservation belongs to other parotidectomy codes. Document the extent of resection, nerve management, tumor involvement, and any neck dissection. CMS classifies the procedure as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 42425
- 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 RVU13.08 · 60%
- Practice expense (office) RVU6.85 · 31%
- Malpractice RVU1.94 · 9%
241
Medicare services in 2024 · #4161 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.
42425 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
This code identifies total parotid excision with unilateral radical neck dissection. Code 42425 identifies total excision with facial nerve sacrifice.
No office rate
42415 is for lateral-lobe excision with facial nerve dissection and preservation, rather than total gland excision with nerve sacrifice.
No office rate
42410 describes lateral-lobe excision without facial nerve dissection; 42425 describes total excision with facial nerve sacrifice.
Compare 42425 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
Kansas →
Office / nonfacility
Unavailable
Facility
$676.37
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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 42425 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,035
- Code
- 42425
- Physician work
- 13.08
- Practice expense
- 6.85
- Malpractice
- 1.94
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.08 | × 1.000 | 13.0800 |
| Practice expense | 6.85 | × 0.904 | 6.1924 |
| Malpractice | 1.94 | × 0.504 | 0.9778 |
| Total RVUs | 20.2502 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$676.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.08 | 1 |
| Practice expense | 6.85 | 0.904 |
| Malpractice | 1.94 | 0.504 |
(13.08 × 1 + 6.85 × 0.904 + 1.94 × 0.504) × $33.4009 = $676.37
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.
42425 billing questions
How does this differ from 42420?
Both describe total parotid excision, but 42425 is for sacrifice of the facial nerve. Code 42420 describes total excision with facial nerve dissection and preservation.
When is 42426 more appropriate?
Use 42426 when the total parotid excision is performed with a unilateral radical neck dissection. Document the neck dissection as part of the operation.
What documentation supports 42425?
The operative report should establish complete parotid excision and facial nerve sacrifice, including the nerve management and tumor extent.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The documentation should support surgery on both sides.
How does the global period affect follow-up billing?
The 90-day major-surgery global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. 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.
5,03242410,,Excise parotid gland/lesion,A,,9.33,5.90,NA,5.90,,1.45,16.68,16.68,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03342415,,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
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958