No office rate
42300 is for a superficial abscess. 42305 is the family option when the drainage is documented as complicated.
On this page
CMS RVU26D · Effective 2026-10-01
42300 Abscess drainage Medicare reimbursement rates in Oklahoma
Reports drainage of a localized superficial abscess involving a salivary gland, rather than drainage requiring a different approach or treatment of a salivary stone. Compare 42300 office and facility rates across CMS payment localities in Oklahoma.
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 42300 in Oklahoma?
Oklahoma 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
$197.38
1 of 1 localities have a supported rate.
Payment area: Oklahoma
One mapped payment locality.
Facility setting
$132.36
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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.
Otolaryngology
About 42300: Superficial salivary gland abscess drainage
Reports drainage of a localized superficial abscess involving a salivary gland, rather than drainage requiring a different approach or treatment of a salivary stone.
This service treats a localized abscess at the superficial portion of a salivary gland by opening the collection and allowing infected material to drain. It is typically performed by an otolaryngologist or oral and maxillofacial surgeon in an office or operating-room setting. The record should identify the affected gland and abscess, describe its superficial location, and document the drainage performed.
Choose this code when the documented service is superficial drainage; use the more specific sibling code when the case is complicated or an intraoral or extraoral approach determines the service. Related postoperative visits during the 10-day global period are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is not appropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 42300
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.93 · 30%
- Practice expense (office) RVU4.23 · 66%
- Malpractice RVU0.26 · 4%
117
Medicare services in 2024 · #4759 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.
42300 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
$168.21
42310 identifies drainage through an intraoral approach; 42300 is selected for a superficial abscess rather than based on that approach distinction.
$240.55
42320 identifies drainage through an extraoral approach. Do not select it solely because the abscess involves a salivary gland.
$218.95
42330 treats a salivary calculus by removal. 42300 is for draining an abscess, not extracting a stone.
Compare 42300 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
Oklahoma →
Office / nonfacility
$197.38
Facility
$132.36
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 42300 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
5,019
- Code
- 42300
- Physician work
- 1.93
- Practice expense
- 4.23
- Malpractice
- 0.26
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.93 | × 1.000 | 1.9300 |
| Practice expense | 4.23 | × 0.893 | 3.7774 |
| Malpractice | 0.26 | × 0.777 | 0.2020 |
| Total RVUs | 5.9094 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Oklahoma$197.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.93 | 1 |
| Practice expense | 4.23 | 0.893 |
| Malpractice | 0.26 | 0.777 |
(1.93 × 1 + 4.23 × 0.893 + 0.26 × 0.777) × $33.4009 = $197.38
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.93 | 1 |
| Practice expense | 2.05 | 0.893 |
| Malpractice | 0.26 | 0.777 |
(1.93 × 1 + 2.05 × 0.893 + 0.26 × 0.777) × $33.4009 = $132.36
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.
42300 billing questions
How is this distinguished from the other salivary abscess drainage codes?
Use 42300 for a superficial abscess. The other codes in this family describe complicated drainage or drainage distinguished by an intraoral or extraoral approach.
Can a salivary stone removal code be reported instead?
No. This service drains an abscess; a stone-removal code describes treatment directed at a salivary calculus. Document the condition and procedure actually treated.
Are related postoperative visits separately reported?
Visits related to the procedure during the 10-day global period are included.
Should modifier 50 be used for bilateral gland involvement?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not append modifier 50.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
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.
5,01642280,,Preparation palate mold,A,,1.55,3.77,,1.17,,0.22,5.54,2.94,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,01742281,,Insertion palate prosthesis,A,,1.93,5.03,,2.40,,0.27,7.23,4.60,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,01842299,,Unlisted px palate uvula,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,01942300,,Drainage of salivary gland,A,,1.93,4.23,,2.05,,0.26,6.42,4.24,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,02042305,,Drainage of salivary gland,A,,6.15,4.47,NA,4.47,,0.90,11.52,11.52,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0214230F,,Anticonv thxpy for 6 mos/>,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
5,02242310,,Drainage of salivary gland,A,,1.57,3.69,,2.04,,0.22,5.48,3.83,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193