Billing code 42420: Parotid excisionMedicare rate & RVUs in Oklahoma
Report total parotid excision when the surgeon removes the gland and dissects and preserves the facial nerve, rather than removing only the lateral lobe.
CMS doesn’t publish an office rate for 42420 in Oklahoma.
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 42420 covers
This operation removes the parotid gland in its entirety, including its superficial and deep portions, while the surgeon identifies, dissects, and preserves the facial nerve. Otolaryngologists and head and neck surgeons typically perform it in an operating room for a parotid neoplasm or other disease requiring removal of the whole gland. The operative report should establish the extent of gland removal and document facial nerve dissection and preservation.
Select this code for total gland excision with nerve preservation, not a lateral-lobe excision or an operation that sacrifices the nerve. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
42420 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $973.07 |
How the 42420 rate is calculated
Each of 42420’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 · 42420
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.04Practice expense 8.84Malpractice 2.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 42420
42420 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42420
Parotid 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 42420
Parotid 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 50 · payment effect
With and without the modifier
42420 without 50 · national facility
$1,025.74
Parotid excision
42420-50 · Bilateral: 150%
$1,538.61
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
42420 compared with similar codes
Compare codes
42420 vs 42415 vs 42425 vs 42426 vs 42410: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 42415Parotid excision
- Use 42415 when excision is limited to the lateral lobe with facial nerve dissection and preservation. This code describes total gland removal.
- 42425Parotidectomy
- This code describes total parotid excision with facial nerve preservation; 42425 is for total excision involving sacrifice of the facial nerve.
- 42426Parotidectomy
- This code describes total parotid excision with facial nerve preservation. The 42426 service includes a unilateral radical neck dissection.
- 42410Parotid excision
- Use 42410 for lateral-lobe excision without facial nerve dissection and preservation. This code involves total gland removal with nerve dissection and preservation.
42420 billing questions
How does this differ from a lateral-lobe parotid excision?
This code describes removal of the whole parotid gland with facial nerve dissection and preservation. A lateral-lobe code is for removal limited to that portion of the gland.
Can this code be used when the facial nerve is sacrificed?
No. This code requires dissection and preservation of the facial nerve. Use the applicable code for total excision involving nerve sacrifice when that is what the operative report documents.
Does the 90-day global period include postoperative visits?
Yes. Related postoperative care through 90 days is included, along with the day-before preoperative visit.
How is this paid when other procedures are performed in the same session?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction. The operative record should support each separately reported procedure.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment for this code.
How should bilateral surgery be reported?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
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
Fee sheets
Put 42420 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →