Billing code 42415: Parotid excisionMedicare rate & RVUs in Oregon
Reports removal of a parotid lesion or lateral gland lobe when the surgeon dissects and preserves the facial nerve during surgery.
CMS doesn’t publish an office rate for 42415 in Oregon.
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 42415 covers
An otolaryngologist or head and neck surgeon reports this operation when removing a lesion from the lateral lobe of the parotid, or removing that lobe, while dissecting and preserving the facial nerve. It may be performed for a parotid mass, such as a benign salivary tumor, in a hospital or other surgical setting. The nerve dissection and preservation are defining features of this service, not simply incidental details of a lesion excision.
Choose the code based on the operative extent and documented facial nerve management, not pathology results alone. The operative report should identify the parotid tissue removed and describe the nerve dissection and preservation. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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.
Where 42415 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $938.48 |
| Rest Of Oregon | Unavailable | $894.19 |
How the 42415 rate is calculated
Each of 42415’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 · 42415
RVUs × geographic indexes × conversion factor
Work16.73
16.73 RVUs× 1.000 GPCI
Practice expense8.31
8.31 RVUs× 1.000 GPCI
Malpractice2.51
2.51 RVUs× 1.000 GPCI
Adjusted RVUs
27.5500
Conversion factor
$33.4009
Medicare rate
$920.19
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 42415
42415 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42415
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 · 42415
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
42415 without 50 · national facility
$920.19
Parotid excision
42415-50 · Bilateral: 150%
$1,380.29
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).
42415 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 42410Parotid excision
- Both describe lateral-lobe parotid excision, but 42415 includes facial nerve dissection and preservation; 42410 does not.
- 42420Parotid excision
- 42420 describes total parotid excision with facial nerve dissection and preservation. Choose 42415 when the operation is limited to the lateral lobe.
- 42400Salivary biopsy
- 42400 is for biopsy of a salivary gland to obtain tissue for diagnosis; 42415 is an operation removing parotid tissue or a lesion with facial nerve dissection and preservation.
42415 billing questions
How does 42415 differ from 42410?
42415 includes dissection and preservation of the facial nerve during lateral-lobe excision. 42410 is for lateral-lobe excision without that nerve dissection and preservation.
When is 42420 more appropriate?
Use 42420 when the operative service removes the total parotid gland with facial nerve dissection and preservation, rather than excising the lateral lobe.
Is facial nerve dissection separately reported?
The dissection and preservation of the facial nerve are part of the service represented by 42415. The operative report should document that work and the extent of parotid removal.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How is bilateral surgery handled?
For bilateral performance, modifier 50 applies, and CMS pays the 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
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