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CPT 42400: Percutaneous Salivary Gland Biopsy

Headline: CPT code 42400: Percutaneous Salivary Gland Biopsy Gains Attention for Diagnostic Role

Lead: CPT code 42400 identifies a percutaneous needle biopsy of a salivary gland — a targeted diagnostic procedure to obtain tissue for pathological analysis. Nationally, this service matters for timely diagnosis of salivary gland masses and can guide surgical and oncologic care.

CPT code 42400 represents a minimally invasive, image-assisted or palpation-guided biopsy procedure performed in outpatient settings to characterize salivary gland lesions. The code is relevant to surgeons, interventional radiologists, otolaryngologists, and pathology services because biopsy results affect treatment planning, surveillance, and potential referrals.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarking context for clinical utilization, payer coverage scope, and common billing considerations tied to outpatient procedure coding. The publication outlines typical service settings, clinical indications that prompt use of the code, and how the procedure integrates with pathological evaluation workflows.

What readers will learn: concise benchmarks for national utilization and payment patterns, the clinical context for ordering a percutaneous salivary gland biopsy, and policy or coverage themes that influence billing and claims processing. Data not available in the input is noted where relevant.

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Billing Code Overview

CPT code 42400 describes a percutaneous needle biopsy of a salivary gland, in which a provider obtains tissue samples via a needle approach and sends those specimens for pathological analysis. This procedure is a diagnostic biopsy used to evaluate masses, lesions, or other abnormalities of the salivary glands.

Service type: Percutaneous salivary gland biopsy (diagnostic tissue sampling)
Typical site of service: Outpatient clinic, ambulatory surgical center, or hospital outpatient department where percutaneous image-guided needle procedures are performed.

Find policies, billing codes, payers, states, and providers

CPT 42400: Percutaneous Salivary Gland Biopsy

Headline: CPT code 42400: Percutaneous Salivary Gland Biopsy Gains Attention for Diagnostic Role

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Get alerted when payer policies referencing 42400 are released or updated.

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Billing Code Overview

Service type: Percutaneous salivary gland biopsy (diagnostic tissue sampling)
Typical site of service: Outpatient clinic, ambulatory surgical center, or hospital outpatient department where percutaneous image-guided needle procedures are performed.

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient presents to the outpatient otolaryngology clinic with a 2.5 cm, firm, nonmobile swelling in the region of the parotid gland noted over several weeks. The clinician performs a focused history and physical exam, reviews prior imaging (ultrasound or CT), and obtains informed consent for a percutaneous salivary gland needle biopsy. The procedure is performed under ultrasound guidance in an ambulatory procedure room or short-stay unit. Local anesthesia is administered, and the provider advances a percutaneous needle into the gland to obtain core or fine-needle aspiration tissue samples which are placed in appropriate media and sent to pathology for cytologic and/or histologic analysis. Post-procedure vital signs and observation are documented, and patient discharge instructions are provided.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s interpretation component when technical component billed separately by another entity.
`50`	Bilateral procedure	Use when biopsy of paired salivary glands (both sides) is performed and payer requires bilateral modifier.
`52`	Reduced services	Use if the biopsy was partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use if the procedure was started but then terminated for patient safety reasons.
`59`	Distinct procedural service	Use to indicate a separate, distinct biopsy procedure performed at a different anatomic site or on a different lesion the same day.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`76`	Repeat procedure by same physician	Use if the same physician repeats the biopsy procedure later the same day.
`77`	Repeat procedure by another physician	Use if a different physician repeats the biopsy later the same day.
`78`	Unplanned return to OR for related procedure during global period	Use if an unplanned return to the operating room is required for a complication related to the biopsy.
`79`	Unrelated procedure or service by same physician during global period	Use if an unrelated procedure is performed during the global period.
`TC`	Technical component	Use when billing only the technical component (facility, equipment, supplies) if the technical portion is billed separately.
`QX`	AD modifier — assistant at surgery (standby)	Use when an assistant-at-surgery who meets requirements is involved and reporting under the assistant modifier rules.
`LT`	Left side	Use to designate left-sided biopsy when laterality is required by payer.
`RT`	Right side	Use to designate right-sided biopsy when laterality is required by payer.

Taxonomy Code	Specialty	Notes
207Y00000X	Otolaryngology (ENT)	Common specialty performing salivary gland biopsies.
2080P0221X	General Surgery	Surgeons may perform salivary gland needle biopsies, especially in operative settings.
207X00000X	Oral and Maxillofacial Surgery	Performs biopsies of salivary gland region in select clinical contexts.
364A00000X	Pathology & Clinical Laboratory	Provides definitive cytologic/histologic analysis of biopsy specimens.
2086S0123X	Radiology – Diagnostic	Interventional radiologists or radiologists may perform image-guided salivary gland biopsies.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K11.5`	Sialadenitis	Inflammation of salivary gland that may prompt biopsy if mass or persistent abnormality is present.
`K11.6`	Sialolithiasis	Salivary gland stone disease; biopsy may be performed if a mass persists or malignancy is suspected.
`C07`	Malignant neoplasm of parotid gland	Primary concern when a suspicious salivary gland mass is present; biopsy is performed to establish diagnosis.
`D11.0`	Benign neoplasm of major salivary glands	Common indication for biopsy to characterize a palpable mass.
`R22.1`	Localized swelling, mass and lump, neck	Non-specific presenting sign that often prompts imaging and biopsy of salivary glands.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`10021`	Fine needle aspiration without imaging guidance	Alternative technique for salivary gland sampling when imaging guidance is not used.
`10022`	Fine needle aspiration with imaging guidance	Used when ultrasound or CT guidance is used to target the salivary gland lesion during aspiration.
`76882`	Ultrasound, soft tissue of head and neck, real-time with image documentation	Commonly performed immediately before or during the biopsy for lesion localization and guidance.
`49405`	Tissue harvest and diagnostic procedure	Used in some contexts for obtaining tissue for diagnosis; may be reported when larger core samples are obtained (facility-dependent).
`88305`	Level IV surgical pathology, gross and microscopic exam	Typical pathology CPT for histologic evaluation of salivary gland core biopsy specimens.

CPT 42405: Open Salivary Gland Biopsy with Pathology

CPT-42408-RANULA-EXCISION-FLOOR-OF-MOUTH

CPT 42408: Excision of Ranula, Floor of Mouth

CPT-42409-MARSUPIALIZATION-SUBLINGUAL-SALIVARY-CYST

CPT 42409: Marsupialization of Sublingual Salivary Cyst

CPT-42410-PAROTID-LATERAL-LOBE-TUMOR-EXCISION-NO-NERVE-DISSECTION

CPT 42410: Excision of Tumor, Lateral Parotid Lobe, No Nerve Dissection

CPT-42415-PAROTID-LATERAL-LOBE-EXCISION-FACIAL-NERVE-PRESERVATION

CPT 42415: Excision of Lateral Parotid Lobe with Facial Nerve Preservation

CPT-42420-PAROTIDECTOMY-FACIAL-NERVE-PRESERVATION

CPT 42420: Parotidectomy with Facial Nerve Dissection and Preservation

CPT-42425-PAROTID-GLAND-REMOVAL-EN-BLOC-WITHOUT-FACIAL-NERVE-PRESERVATION

CPT 42425: Parotid Gland Removal with Tumor, No Facial Nerve Preservation

CPT-42426-PAROTIDECTOMY-TOTAL-WITH-RADICAL-NECK-DISSECTION-UNILATERAL

CPT 42426: Total Parotidectomy with Unilateral Radical Neck Dissection

CPT-42440-SUBMANDIBULAR-GLAND-EXCISION

CPT 42440: Submandibular Gland Excision

CPT-42450-SUBLINGUAL-GLAND-EXCISION

CPT 42450: Sublingual Gland Excision

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s interpretation component when technical component billed separately by another entity.
`50`	Bilateral procedure	Use when biopsy of paired salivary glands (both sides) is performed and payer requires bilateral modifier.
`52`	Reduced services	Use if the biopsy was partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use if the procedure was started but then terminated for patient safety reasons.
`59`	Distinct procedural service	Use to indicate a separate, distinct biopsy procedure performed at a different anatomic site or on a different lesion the same day.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`76`	Repeat procedure by same physician	Use if the same physician repeats the biopsy procedure later the same day.
`77`	Repeat procedure by another physician	Use if a different physician repeats the biopsy later the same day.
`78`	Unplanned return to OR for related procedure during global period	Use if an unplanned return to the operating room is required for a complication related to the biopsy.
`79`	Unrelated procedure or service by same physician during global period	Use if an unrelated procedure is performed during the global period.
`TC`	Technical component	Use when billing only the technical component (facility, equipment, supplies) if the technical portion is billed separately.
`QX`	AD modifier — assistant at surgery (standby)	Use when an assistant-at-surgery who meets requirements is involved and reporting under the assistant modifier rules.
`LT`	Left side	Use to designate left-sided biopsy when laterality is required by payer.
`RT`	Right side	Use to designate right-sided biopsy when laterality is required by payer.

Taxonomy Code	Specialty	Notes
207Y00000X	Otolaryngology (ENT)	Common specialty performing salivary gland biopsies.
2080P0221X	General Surgery	Surgeons may perform salivary gland needle biopsies, especially in operative settings.
207X00000X	Oral and Maxillofacial Surgery	Performs biopsies of salivary gland region in select clinical contexts.
364A00000X	Pathology & Clinical Laboratory	Provides definitive cytologic/histologic analysis of biopsy specimens.
2086S0123X	Radiology – Diagnostic	Interventional radiologists or radiologists may perform image-guided salivary gland biopsies.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K11.5`	Sialadenitis	Inflammation of salivary gland that may prompt biopsy if mass or persistent abnormality is present.
`K11.6`	Sialolithiasis	Salivary gland stone disease; biopsy may be performed if a mass persists or malignancy is suspected.
`C07`	Malignant neoplasm of parotid gland	Primary concern when a suspicious salivary gland mass is present; biopsy is performed to establish diagnosis.
`D11.0`	Benign neoplasm of major salivary glands	Common indication for biopsy to characterize a palpable mass.
`R22.1`	Localized swelling, mass and lump, neck	Non-specific presenting sign that often prompts imaging and biopsy of salivary glands.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`10021`	Fine needle aspiration without imaging guidance	Alternative technique for salivary gland sampling when imaging guidance is not used.
`10022`	Fine needle aspiration with imaging guidance	Used when ultrasound or CT guidance is used to target the salivary gland lesion during aspiration.
`76882`	Ultrasound, soft tissue of head and neck, real-time with image documentation	Commonly performed immediately before or during the biopsy for lesion localization and guidance.
`49405`	Tissue harvest and diagnostic procedure	Used in some contexts for obtaining tissue for diagnosis; may be reported when larger core samples are obtained (facility-dependent).
`88305`	Level IV surgical pathology, gross and microscopic exam	Typical pathology CPT for histologic evaluation of salivary gland core biopsy specimens.

CPT 42405: Open Salivary Gland Biopsy with Pathology

CPT-42408-RANULA-EXCISION-FLOOR-OF-MOUTH

CPT 42408: Excision of Ranula, Floor of Mouth

CPT-42409-MARSUPIALIZATION-SUBLINGUAL-SALIVARY-CYST

CPT 42409: Marsupialization of Sublingual Salivary Cyst

CPT-42410-PAROTID-LATERAL-LOBE-TUMOR-EXCISION-NO-NERVE-DISSECTION

CPT 42410: Excision of Tumor, Lateral Parotid Lobe, No Nerve Dissection

CPT-42415-PAROTID-LATERAL-LOBE-EXCISION-FACIAL-NERVE-PRESERVATION

CPT 42415: Excision of Lateral Parotid Lobe with Facial Nerve Preservation

CPT-42420-PAROTIDECTOMY-FACIAL-NERVE-PRESERVATION

CPT 42420: Parotidectomy with Facial Nerve Dissection and Preservation

CPT-42425-PAROTID-GLAND-REMOVAL-EN-BLOC-WITHOUT-FACIAL-NERVE-PRESERVATION

CPT 42425: Parotid Gland Removal with Tumor, No Facial Nerve Preservation

CPT-42426-PAROTIDECTOMY-TOTAL-WITH-RADICAL-NECK-DISSECTION-UNILATERAL

CPT 42426: Total Parotidectomy with Unilateral Radical Neck Dissection

CPT-42440-SUBMANDIBULAR-GLAND-EXCISION

CPT 42440: Submandibular Gland Excision

CPT-42450-SUBLINGUAL-GLAND-EXCISION

CPT 42450: Sublingual Gland Excision

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 42400: Percutaneous Salivary Gland Biopsy

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Billing Code Overview

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CPT 42400: Percutaneous Salivary Gland Biopsy

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 42400: Percutaneous Salivary Gland Biopsy

Sign up for cpt 42400 policy alerts

Billing Code Overview

CPT 42400: Percutaneous Salivary Gland Biopsy

Sign up for cpt 42400 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 42400 represent and where is the procedure usually performed?

Which CPT codes are commonly reported alongside or instead of 42400?

What modifiers are relevant when billing CPT 42400 and when should they be used?

Which specialties and taxonomy codes are commonly involved with percutaneous salivary gland biopsy?

Which payers are included in the coverage analysis for CPT 42400 and does the page provide reimbursement rates?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 42400 represent and where is the procedure usually performed?

Which CPT codes are commonly reported alongside or instead of 42400?

What modifiers are relevant when billing CPT 42400 and when should they be used?

Which specialties and taxonomy codes are commonly involved with percutaneous salivary gland biopsy?

Which payers are included in the coverage analysis for CPT 42400 and does the page provide reimbursement rates?

References