Billing code 42550: Sialography injectionMedicare rate & RVUs in Nebraska
Reports contrast injection into a salivary duct to outline the gland’s ductal system during a diagnostic sialography examination.
Medicare pays $136.60 for 42550 in the office in Nebraska (Nebraska). 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 42550 covers
An otolaryngologist, oral and maxillofacial surgeon, or radiologist may cannulate a salivary duct opening and inject contrast to outline the ductal system. The study can help evaluate recurrent gland swelling or suspected duct obstruction, including a possible salivary stone. The injection is performed as part of a diagnostic sialography examination, commonly in a facility imaging setting.
Report 42550 for the injection work, supported by documentation identifying the gland or duct accessed and the contrast injection performed. The radiologic supervision and interpretation may be reported with 70390 when performed and separately reportable. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery reporting are not permitted for this code.
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.
42550 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | $136.60 | $49.05 |
How the 42550 rate is calculated
Each of 42550’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 · 42550
RVUs × geographic indexes × conversion factor
Work1.22
1.22 RVUs× 1.000 GPCI
Practice expense3.06
3.06 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
4.4000
Conversion factor
$33.4009
Medicare rate
$146.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42550
The CMS indicators that decide how 42550 is paid alongside other services.
CMS payment indicators · 42550
Sialography injection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42550 without 51 · national office
$146.96
Sialography injection
42550-51 · Second procedure: 50%
$73.48
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%).
42550 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 70390Salivary duct imaging
- 42550 reports contrast injection into the salivary duct; 70390 reports radiologic supervision and interpretation of the sialogram.
- 42500Duct repair
- 42500 is a salivary duct repair procedure. Use 42550 for diagnostic contrast injection rather than duct repair.
- 42505Salivary duct repair
- 42505 describes salivary duct repair, not the contrast injection performed for a sialogram.
42550 billing questions
How does 42550 differ from 70390?
42550 represents the salivary duct contrast injection. Code 70390 represents radiologic supervision and interpretation for sialography when that service is performed and separately reportable.
What documentation supports 42550?
Document the clinical reason for the study, the salivary gland or duct accessed, and the contrast injection performed. The record should also support the associated sialography service when it is reported.
Should modifier 50 be used for bilateral imaging?
No. CMS identifies bilateral adjustment as inappropriate for 42550, so do not use modifier 50 for bilateral reporting.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. The 0-day global period does not include care on later dates.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 42550. Co-surgeon and team-surgery reporting are not permitted.
How is 42550 affected by other procedures in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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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