$429.74
42500 is for simple repair of a salivary duct. Choose 42507 when the surgeon diverts both parotid ducts rather than repairing a duct.
On this page
CMS RVU26D · Effective 2026-10-01
42507 Parotid duct diversion Medicare reimbursement rates in Utah
Reports bilateral redirection of parotid saliva, typically as surgery to manage severe drooling when the operative plan diverts both parotid ducts. Compare 42507 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 42507 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
$426.02
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.
Otolaryngology surgery
About 42507: Bilateral parotid duct diversion
Reports bilateral redirection of parotid saliva, typically as surgery to manage severe drooling when the operative plan diverts both parotid ducts.
This operation redirects saliva from both parotid ducts, which carry saliva from the parotid glands into the mouth. Otolaryngologists and other surgeons who treat salivary-duct disorders may perform it, including in patients with severe drooling for whom the treatment plan redirects salivary flow. The operative report should identify the ducts treated and describe the diversion performed; a repair that restores a damaged duct is a different service.
Report this code when the documented operation includes bilateral parotid duct diversion. CMS prices the code as bilateral, so modifier 50 does not increase payment. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are not permitted.
CMS billing rules for 42507
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.09 · 46%
- Practice expense (office) RVU6.24 · 47%
- Malpractice RVU0.89 · 7%
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.
42507 compared with similar codes
Office rates for Utah, from the same CMS release.
$550.79
42505 is for complicated salivary duct repair. It does not describe redirecting both parotid ducts.
No office rate
Both codes concern parotid duct diversion. Compare the code descriptor with the operative report's documented procedure and laterality before selecting the code.
No office rate
This is another parotid duct diversion option. Select between the family codes using the operative details and the distinctions in their descriptors.
Compare 42507 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
$426.02
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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 42507 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,044
- Code
- 42507
- Physician work
- 6.09
- Practice expense
- 6.24
- Malpractice
- 0.89
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.09 | × 1.000 | 6.0900 |
| Practice expense | 6.24 | × 0.940 | 5.8656 |
| Malpractice | 0.89 | × 0.898 | 0.7992 |
| Total RVUs | 12.7548 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$426.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.09 | 1 |
| Practice expense | 6.24 | 0.94 |
| Malpractice | 0.89 | 0.898 |
(6.09 × 1 + 6.24 × 0.94 + 0.89 × 0.898) × $33.4009 = $426.02
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.
42507 billing questions
When should this code be selected instead of a parotid duct repair code?
Use this code for documented diversion of both parotid ducts. Codes 42500 and 42505 describe duct repair, not intentional redirection of salivary flow.
Should modifier 50 be appended?
No. CMS prices this code as bilateral, and modifier 50 does not increase payment.
What documentation supports reporting the bilateral service?
The operative report should identify treatment of both parotid ducts and describe the diversion performed. Documentation of only one duct does not support the bilateral service.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can another procedure performed in the same session be separately paid?
Other procedures may be reported when independently supported, but CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full and others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeons and team surgery are not permitted for this code.
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.
5,0414248F,,Pt instr no bd rest 4 days/>,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
5,04242500,,Repair salivary duct,A,,4.31,8.51,,4.45,,0.62,13.44,9.38,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,04342505,,Repair salivary duct,A,,6.16,10.13,,5.22,,0.90,17.19,12.28,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,04442507,,Parotid duct diversion,A,,6.09,6.24,NA,6.24,,0.89,13.22,13.22,0,090,0.09,0.81,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,04542509,,Parotid duct diversion,A,,11.47,8.38,NA,8.38,,1.67,21.52,21.52,0,090,0.09,0.81,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,0464250F,,Wrmng 4 surg normothermia,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
5,04742510,,Parotid duct diversion,A,,8.14,6.75,NA,6.75,,1.20,16.09,16.09,0,090,0.09,0.81,0.10,2,2,2,1,0,9,,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