Billing code 42450: Gland excisionMedicare rate & RVUs in Minnesota
Removal of the sublingual salivary gland, commonly performed for disease involving the gland or as part of treatment for a recurrent ranula.
Medicare pays $465.01 for 42450 in the office in Minnesota (Minnesota). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 42450 covers
This operation removes the sublingual salivary gland, which lies in the floor of the mouth beneath the tongue. An otolaryngologist or oral and maxillofacial surgeon typically performs it in a hospital or ambulatory surgical setting. The operative report should identify the sublingual gland as the structure removed and describe the reason for excision, such as gland disease or treatment of a recurrent ranula.
Report this code for removal of the sublingual gland, not for sampling a gland or treating only a discrete cyst. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
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.
42450 in Minnesota
| Payment locality | Office | Facility |
|---|---|---|
| Minnesota | $465.01 | $318.25 |
How the 42450 rate is calculated
Each of 42450’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 42450
RVUs × geographic indexes × conversion factor
Work4.62
4.62 RVUs× 1.000 GPCI
Practice expense8.85
8.85 RVUs× 1.000 GPCI
Malpractice0.66
0.66 RVUs× 1.000 GPCI
Adjusted RVUs
14.1300
Conversion factor
$33.4009
Medicare rate
$471.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42450
42450 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42450
Gland excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 42450
Gland excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42450 without 51 · national office
$471.95
Gland excision
42450-51 · Second procedure: 50%
$235.98
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
42450 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 42440Salivary gland excision
- Choose 42450 for the sublingual gland beneath the tongue; choose 42440 for the submaxillary, or submandibular, gland.
- 42400Salivary biopsy
- 42400 represents salivary gland biopsy. Use 42450 when the sublingual gland itself is removed rather than sampled.
- 42408Salivary cyst
- 42408 is for excision of a salivary cyst. Choose 42450 when the operative target is removal of the sublingual gland.
- 42410Parotid excision
- 42410 concerns excision involving the parotid gland or a parotid lesion; 42450 concerns the sublingual gland.
42450 billing questions
How does this differ from submaxillary gland excision?
This code is for removal of the sublingual gland beneath the tongue. Code 42440 is for removal of the submaxillary, or submandibular, gland.
Can this code be used for a salivary gland biopsy?
No. Use a biopsy code when tissue is sampled without removing the sublingual gland; this code represents gland excision.
Is modifier 50 appropriate when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant at surgery payable?
Only when the record documents medical necessity for the assistant. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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