Summary & Overview
CPT 42335: Sialolithotomy, Removal of Salivary Gland Stone
CPT code 42335 denotes sialolithotomy, the surgical removal of a salivary gland stone. This procedure addresses obstructive sialadenitis, pain, and infection risk caused by sialoliths and is an important, though infrequent, surgical intervention in oral and maxillofacial practice. Nationally, proper coding ensures accurate claims processing, appropriate site-of-service reporting, and tracking of procedural utilization for surgical and dental services.
Key payers referenced in analyses typically include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for 42335, typical sites of service, and common practice patterns. The publication presents benchmarks for utilization and reimbursement where available, summarizes relevant billing and documentation considerations, and highlights policy updates that affect coverage and payment across major national payers.
This report is intended for billing professionals, surgical and dental practice administrators, and policy analysts seeking concise information on the clinical purpose of CPT code 42335, payer coverage landscape, and operational implications for outpatient surgical services. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 42335 describes sialolithotomy, the surgical removal of a stone (sialolith) from a salivary gland. This procedure is performed to relieve ductal obstruction, infection risk, and pain associated with salivary gland stones.
Service Type: Surgical removal of salivary gland stone
Typical Site of Service: Ambulatory surgical center or hospital outpatient department, and occasionally office-based surgical settings depending on complexity and anesthesia needs.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old adult presenting to an otolaryngology clinic with acute submandibular gland pain and swelling, often worse with meals, consistent with obstructive sialolithiasis. After clinical examination and ultrasound or CT confirmation of a salivary gland stone, conservative measures (hydration, sialogogues, massage, antibiotics if infected) are attempted. When conservative therapy fails or the stone is accessible only via surgical removal, the patient is scheduled for a 42335 sialolithotomy. The procedure is performed in an outpatient ambulatory surgery center or hospital operating room under local anesthesia with sedation or general anesthesia depending on stone location and patient factors. The workflow includes preoperative consent and imaging review, intraoperative localization and incision into the duct or gland to extract the calculus, hemostasis, possible duct repair or stenting, and postoperative instructions addressing oral hygiene, pain control, and follow-up to assess gland function and wound healing. Typical postprocedure documentation includes operative report with stone size/location, approach (intraoral vs external), anesthesia type, any complications, and disposition (same-day discharge or brief observation).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use if work or complexity substantially exceeds typical for and must be supported in op note. |