Billing code 42425: ParotidectomyMedicare rate & RVUs in Oregon
Reports complete removal of a parotid gland and tumor with facial nerve sacrifice, typically when the tumor involves the nerve.
CMS doesn’t publish an office rate for 42425 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 42425 covers
This operation removes the entire parotid gland and tumor while sacrificing the facial nerve, typically because the tumor involves or encases the nerve. An otolaryngologist or head-and-neck surgeon performs it in an operating room, often for an extensive parotid neoplasm. Sacrificing the nerve can cause facial weakness or paralysis on the operated side.
Report this code when the operative report supports total gland excision and facial nerve sacrifice; lateral-lobe removal or nerve preservation belongs to other parotidectomy codes. Document the extent of resection, nerve management, tumor involvement, and any neck dissection. CMS classifies the procedure as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant may be paid; 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.
Where 42425 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $746.28 |
| Rest Of Oregon | Unavailable | $710.32 |
How the 42425 rate is calculated
Each of 42425’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 · 42425
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.08Practice expense 6.85Malpractice 1.94
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 42425
42425 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42425
Parotidectomy
| 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 · 42425
Parotidectomy
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
42425 without 50 · national facility
$730.48
Parotidectomy
42425-50 · Bilateral: 150%
$1,095.72
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).
42425 compared with similar codes
Compare codes
42425 vs 42420 vs 42426 vs 42415 vs 42410: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 42420Parotid excision
- Both involve total parotid excision. Choose 42425 when the facial nerve is sacrificed; choose 42420 when it is dissected and preserved.
- 42426Parotidectomy
- This code identifies total parotid excision with unilateral radical neck dissection. Code 42425 identifies total excision with facial nerve sacrifice.
- 42415Parotid excision
- 42415 is for lateral-lobe excision with facial nerve dissection and preservation, rather than total gland excision with nerve sacrifice.
- 42410Parotid excision
- 42410 describes lateral-lobe excision without facial nerve dissection; 42425 describes total excision with facial nerve sacrifice.
42425 billing questions
How does this differ from 42420?
Both describe total parotid excision, but 42425 is for sacrifice of the facial nerve. Code 42420 describes total excision with facial nerve dissection and preservation.
When is 42426 more appropriate?
Use 42426 when the total parotid excision is performed with a unilateral radical neck dissection. Document the neck dissection as part of the operation.
What documentation supports 42425?
The operative report should establish complete parotid excision and facial nerve sacrifice, including the nerve management and tumor extent.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The documentation should support surgery on both sides.
How does the global period affect follow-up billing?
The 90-day major-surgery global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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 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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