Summary & Overview
CPT 42330: Sialolithotomy, Removal of Salivary Gland Stone
CPT code 42330 denotes sialolithotomy, the surgical removal of salivary gland stones that obstruct saliva flow. This procedure is clinically significant nationwide because salivary calculi can cause recurrent pain, infection, and impaired oral function; removal often resolves symptoms and prevents complications. The code applies to procedures on the parotid, submandibular, and sublingual glands and is relevant to otolaryngology, oral and maxillofacial surgery, and general surgical services.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and common billing considerations tied to CPT code 42330. The publication summarizes benchmarks and utilization patterns where available, explains how the code fits into surgical service lines, and highlights policy or coding updates that affect billing and coverage interpretations.
This summary is intended for a national audience of billing managers, clinicians, and policy analysts seeking a practical reference on clinical purpose, payer relevance, and the operational setting for CPT code 42330. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 42330 describes sialolithotomy, the surgical removal of a stone (sialolith) from a salivary gland. The procedure addresses obstruction of salivary flow caused by calculi within the parotid, submandibular, or sublingual glands, restoring gland function and relieving pain or swelling.
Service Type: Surgical procedure — minor head and neck/otolaryngology procedure
Typical Site of Service: Ambulatory surgical center or hospital outpatient department; procedure may also be performed in an office setting when appropriate for the clinical situation.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an otolaryngology clinic with acute unilateral submandibular swelling, intermittent pain and increased swelling at mealtimes, and possible low-grade fever. Examination and ultrasound confirm a sialolith obstructing the submandibular duct (Wharton's duct). Conservative measures such as hydration, sialogogues, and massage were attempted; symptoms persisted or the stone is large/firm and located within the gland or duct. The patient is scheduled for 42330 (sialolithotomy) performed under local or general anesthesia in an outpatient ambulatory surgery center or hospital operating room. The clinical workflow includes preoperative imaging review (ultrasound or CT), informed consent, anesthesia evaluation, intraoperative localization and incision of the duct, removal of the calculus, ductal repair or stenting if needed, hemostasis, and postoperative instructions with short-term antibiotics or analgesics as indicated. Typical site of service is the oral cavity/upper aerodigestive tract with providers commonly being otolaryngologists (ENT) or oral and maxillofacial surgeons.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work is substantially greater than typical for 42330 due to extensive dissection or prolonged operative time. |