No office rate
Both involve lateral-lobe parotid surgery, but 42415 includes formal facial-nerve dissection and preservation. Use 42410 when that nerve dissection is not performed.
On this page
CMS RVU26D · Effective 2026-10-01
42410 Parotid excision Medicare reimbursement rates in Utah
Reports removal of a parotid lesion or lateral gland tissue when the surgeon does not formally dissect the facial nerve. Compare 42410 office and facility rates across CMS payment localities in Utah.
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 42410 in Utah?
Utah 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
No supported rate
Facility setting
$540.36
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Salivary gland surgery
About 42410: Lateral parotid lesion or gland excision
Reports removal of a parotid lesion or lateral gland tissue when the surgeon does not formally dissect the facial nerve.
Code 42410 describes surgery to remove a lesion or tissue from the lateral portion of the parotid gland without formal dissection of the facial nerve. Otolaryngologists and head and neck surgeons commonly perform the operation in a hospital or ambulatory surgery setting for a localized parotid mass requiring excision rather than diagnostic sampling. The operative report should identify the site and extent of removal and describe the facial-nerve approach.
Choose this code when the resection is limited to the lateral lobe and the facial nerve is not formally dissected; use a different parotid code when the extent or nerve work differs. The service has 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%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 42410
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.33 · 56%
- Practice expense (office) RVU5.90 · 35%
- Malpractice RVU1.45 · 9%
827
Medicare services in 2024 · #3118 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.
42410 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
42420 describes total parotid removal with facial-nerve dissection and preservation. It is not the limited lateral-lobe procedure reported with 42410.
$90.26
42400 is for salivary-gland biopsy and diagnostic tissue sampling. Use 42410 when the surgeon excises the lateral parotid lesion or gland tissue.
$544.13
42408 describes excision of a salivary cyst. Use 42410 for excision involving the lateral parotid gland rather than a salivary cyst procedure.
Compare 42410 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
Utah →
Office / nonfacility
Unavailable
Facility
$540.36
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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 42410 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,032
- Code
- 42410
- Physician work
- 9.33
- Practice expense
- 5.90
- Malpractice
- 1.45
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.33 | × 1.000 | 9.3300 |
| Practice expense | 5.90 | × 0.940 | 5.5460 |
| Malpractice | 1.45 | × 0.898 | 1.3021 |
| Total RVUs | 16.1781 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$540.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.33 | 1 |
| Practice expense | 5.9 | 0.94 |
| Malpractice | 1.45 | 0.898 |
(9.33 × 1 + 5.9 × 0.94 + 1.45 × 0.898) × $33.4009 = $540.36
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.
42410 billing questions
How does 42410 differ from 42415?
Both describe lateral-lobe parotid surgery. Use 42415 when the surgeon formally dissects and preserves the facial nerve; 42410 is for lateral-lobe removal without that nerve dissection.
When is 42420 a better fit?
Use 42420 for removal of the entire parotid gland with facial-nerve dissection and preservation, rather than a lateral-lobe resection.
Can a parotid biopsy be reported instead?
A biopsy code describes diagnostic tissue sampling, not removal of the lateral lobe or a lesion as definitive surgery. Select the code that matches the actual procedure documented.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Do not separately report routine care included in that period.
How does Medicare treat bilateral reporting and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 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.
5,02942408,,Excision of salivary cyst,A,,4.54,11.88,,4.52,,0.65,17.07,9.71,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03042409,,Drainage of salivary cyst,A,,2.84,8.33,,3.04,,0.42,11.59,6.30,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0314240F,,Instr xrcz back pain 12 wks,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
5,03242410,,Excise parotid gland/lesion,A,,9.33,5.90,NA,5.90,,1.45,16.68,16.68,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03342415,,Excise parotid gland/lesion,A,,16.73,8.31,NA,8.31,,2.51,27.55,27.55,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03442420,,Excise parotid gland/lesion,A,,19.04,8.84,NA,8.84,,2.83,30.71,30.71,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,03542425,,Excise parotid gland/lesion,A,,13.08,6.85,NA,6.85,,1.94,21.87,21.87,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985