42440 Salivary gland excision Medicare reimbursement rates in Massachusetts

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.