Summary & Overview
CPT 42415: Excision of Lateral Parotid Lobe with Facial Nerve Preservation
CPT code 42415 denotes surgical excision of the lateral lobe of a parotid tumor or the parotid gland with dissection and preservation of the facial nerve. This procedure is clinically significant because it balances definitive tumor removal with functional preservation of facial nerve function, affecting patient outcomes, perioperative planning, and post-operative care across the country. The code is commonly used for benign and malignant parotid neoplasms where nerve-sparing approaches are feasible.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical settings and clinical context, billing and coding considerations tied to parotidectomy procedures, common modifiers used with operative billing, and comparative benchmarks where available. The report summarizes reimbursement patterns, utilization trends, and policy updates affecting surgical head and neck services, and highlights documentation expectations tied to nerve dissection and gland excision.
This publication is intended for billing professionals, surgical teams, and policy analysts seeking a concise reference on coding and payer considerations for parotid gland excision with facial nerve preservation. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 42415 describes excision of the lateral lobe of a parotid tumor or the parotid gland with dissection and preservation of the facial nerve. This is a surgical procedure performed by otolaryngology-head and neck surgeons or oral and maxillofacial surgeons focused on removal of parotid gland tissue while identifying and preserving the facial nerve.
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Service type: Surgical excision of parotid gland or parotid tumor with facial nerve dissection
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Typical site of service: Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55-year-old with a slowly enlarging, painless mass in the preauricular region. Evaluation includes history, physical exam, ultrasound and contrast-enhanced MRI to define the lesion within the superficial (lateral) lobe of the parotid gland. Fine-needle aspiration biopsy or core needle biopsy is often performed preoperatively to clarify benign versus malignant histology. The operative plan is a lateral parotidectomy with careful identification, dissection, and preservation of the facial nerve trunk and branches. The procedure is performed in an ambulatory surgical center or hospital operating room under general anesthesia with facial nerve monitoring. Postoperative workflow includes short-term observation or inpatient stay if indicated, wound care instructions, drain management if placed, follow-up for pathology results, and scheduled facial nerve function assessment and rehabilitation as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the surgeon's professional service separate from technical facility charges. |
50 | Bilateral procedure | Use when bilateral parotidectomy is performed and payer allows bilateral modifier for this service. |