$70.83
Use 42650 for the less complex dilation level. Use 42660 when the operative details support a complicated dilation.
On this page
CMS RVU26D · Effective 2026-10-01
42660 Salivary duct dilation Medicare reimbursement rates in Nebraska
Report this service for a complicated dilation of a narrowed salivary duct, such as the parotid or submandibular duct, to restore drainage. Compare 42660 office and facility rates across CMS payment localities in Nebraska.
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 42660 in Nebraska?
Nebraska 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
$94.25
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$64.66
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Salivary gland surgery
About 42660: Complicated salivary duct dilation
Report this service for a complicated dilation of a narrowed salivary duct, such as the parotid or submandibular duct, to restore drainage.
An otolaryngologist or oral and maxillofacial surgeon may dilate a narrowed salivary duct to improve saliva flow. The procedure may address stenosis in the parotid duct or a submandibular duct, often associated with obstructive symptoms such as recurrent gland swelling around meals. Code 42660 distinguishes a complicated dilation from a less complex duct dilation; the operative record should make the nature of the added complexity clear.
Select the code based on the procedure performed and its documented complexity, not symptoms alone. Record the duct treated, the narrowing or obstruction, the technique, and the work supporting the complicated level. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 42660
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.10 · 36%
- Practice expense (office) RVU1.80 · 59%
- Malpractice RVU0.16 · 5%
332
Medicare services in 2024 · #3915 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.
42660 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$339.71
42665 describes ligation of a salivary duct, which closes the duct; 42660 dilates a narrowed duct to improve its patency.
42699
No office rateUnlisted px salivry glnd/dux
Use 42660 when the service is a complicated salivary duct dilation. Reserve 42699 for a salivary duct procedure that lacks a specific listed code.
Compare 42660 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
Nebraska →
Office / nonfacility
$94.25
Facility
$64.66
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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 42660 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
5,056
- Code
- 42660
- Physician work
- 1.10
- Practice expense
- 1.80
- Malpractice
- 0.16
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.10 | × 1.000 | 1.1000 |
| Practice expense | 1.80 | × 0.923 | 1.6614 |
| Malpractice | 0.16 | × 0.378 | 0.0605 |
| Total RVUs | 2.8219 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$94.25
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.1 | 1 |
| Practice expense | 1.8 | 0.923 |
| Malpractice | 0.16 | 0.378 |
(1.1 × 1 + 1.8 × 0.923 + 0.16 × 0.378) × $33.4009 = $94.25
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.1 | 1 |
| Practice expense | 0.84 | 0.923 |
| Malpractice | 0.16 | 0.378 |
(1.1 × 1 + 0.84 × 0.923 + 0.16 × 0.378) × $33.4009 = $64.66
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.
42660 billing questions
How is 42660 distinguished from 42650?
42660 is for a complicated dilation; 42650 represents the less complex level. Document the procedural details that support the complicated level rather than relying on the diagnosis alone.
Can modifier 50 be reported for bilateral duct dilation?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
How are other procedures performed in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
What documentation supports this code?
Document the salivary duct treated, the narrowing or obstruction, the dilation technique, and the details establishing that the procedure was complicated rather than less complex.
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.
5,0534261F,,Tech other than surfc cultr,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
5,05442650,,Dilation of salivary duct,A,,0.75,1.44,,0.74,,0.11,2.30,1.60,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0554265F,,Wet-dry dressings rx recmd,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
5,05642660,,Dilation of salivary duct,A,,1.10,1.80,,0.84,,0.16,3.06,2.10,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,05742665,,Ligation of salivary duct,A,,2.56,8.09,,2.97,,0.38,11.03,5.91,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0584266F,,No wet-dry drssings rx recmd,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
5,0594267F,,Comprssion thxpy prescribed,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068