Billing code 42660: Salivary duct dilationMedicare rate & RVUs in Ohio
Report this service for a complicated dilation of a narrowed salivary duct, such as the parotid or submandibular duct, to restore drainage.
Medicare pays $97.02 for 42660 in the office in Ohio (Ohio). 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 42660 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $97.02 | $67.74 |
How the 42660 rate is calculated
Each of 42660’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 · 42660
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.10Practice expense 1.80Malpractice 0.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 42660
The CMS indicators that decide how 42660 is paid alongside other services.
CMS payment indicators · 42660
Salivary duct dilation
| 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) | 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42660 without 51 · national office
$102.21
Salivary duct dilation
42660-51 · Second procedure: 50%
$51.11
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%).
42660 compared with similar codes
Compare codes
42660 vs 42650 vs 42665 vs 42699: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 42650Salivary duct dilation
- Use 42650 for the less complex dilation level. Use 42660 when the operative details support a complicated dilation.
- 42665Salivary duct surgery
- 42665 describes ligation of a salivary duct, which closes the duct; 42660 dilates a narrowed duct to improve its patency.
- 42699Unlisted 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.
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 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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