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CMS RVU26D · Effective 2026-10-01

42510 Parotid duct diversion Medicare reimbursement rates in Michigan

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 Michigan.

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 Michigan?

Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$522.98–$557.03

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $34.05 per service.

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.

Find 42510 in your payment locality →

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 Michigan, from the same CMS release.

42507

Parotid duct diversion

Bilateral procedure

No office rate

Use 42507 for intraoral parotid duct diversion. Code 42510 is priced as bilateral, rather than identifying the intraoral approach.

42509

Parotid duct diversion

Bilateral

No office rate

Use 42509 for extraoral parotid duct diversion. Code 42510 is priced as bilateral, rather than identifying the extraoral approach.

42500

Duct repair

Salivary duct

$426.85–$453.17

Code 42500 describes simple salivary duct repair. Choose diversion when the operation reroutes parotid drainage instead of repairing the duct.

42505

Salivary duct repair

Secondary, complicated

$548.60–$582.94

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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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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.

RVUs for 42510PPRRVU2026_Oct_nonQPP.csv, line 5,047 (RVU26D)