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    OpenPayerBilling CodesExcision Procedures on the Salivary Gland and DuctsCPT cpt-42420-parotidectomy-facial-nerve-preservation
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    CPT 42420: Parotidectomy with Facial Nerve Preservation

    Medicare pays $1043 on average nationally for this procedure.

    CPT code 42420 describes surgical removal of a parotid gland tumor with dissection and preservation of the facial nerve, a head and neck surgical procedure typically performed in an operating room as a parotidectomy for tumor excision; the service involves tumor resection, identification and careful separation of the facial nerve branches, and associated soft-tissue management under general anesthesia.

    For related coverage guidance, see recent payer policy updates: Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Members, Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policy, Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP]).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 55-year-old adult presenting with a slowly enlarging, painless mass over the preauricular region. Imaging (ultrasound and contrast-enhanced MRI or CT) and fine-needle aspiration suggest a parotid neoplasm suspicious for malignancy or a benign tumor causing cosmetic or functional concerns. The patient undergoes preoperative evaluation including history, physical exam focused on facial nerve function, laboratory studies, and anesthesia assessment. In the operating room under general anesthesia, the surgeon performs a parotidectomy with careful dissection and identification of the facial nerve branches, removes the tumor-bearing gland or portion of the gland, and preserves motor function of the facial nerve when feasible. Intraoperative nerve monitoring may be used. Postoperative care includes facial nerve function assessment, wound care, pain control, and pathology review to determine need for adjuvant therapy such as radiation. Typical site of service is an inpatient or outpatient hospital operating room or ambulatory surgery center. Service type: surgical, otolaryngology/head and neck surgical procedure.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    69990Description: Microsurgical techniques, requiring use of an operating microscope (List separately in addition to code for primary procedure)Often reported when operative microscope is used for fine facial nerve dissection during parotidectomy
    61618Description: Stereotactic radiosurgery procedure, cranial lesion; percutaneous — (example code included as related for skull base access)May be used for adjacent skull-base lesions; rarely directly related but included when skull-base approaches are necessary
    69210Description: Removal of foreign body from external ear canal; simpleUnrelated minor ENT procedures performed in same session would be listed with 42420 using modifier 51 if distinct
    61624Description: Stereotactic radiosurgery, per lesion, cranialMay be part of multidisciplinary care when adjuvant radiosurgery is indicated for residual tumor
    31620Description: Tracheostomy, planned or emergency (separate procedure)Included as a code that may be performed in complex head and neck oncologic resections requiring airway management

    Note: If additional specific related CPT codes are required for a particular facility workflow or payer bundle, verify local coding guidance. The listed codes represent procedures that may be performed before, during, or after parotidectomy in complex oncologic or reconstructive cases.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Y00000X
    207K00000X
    363L00000X
    207RH0000X
    2083P0500X
    2085R0204X
    207PS0010X
    225XE1200X

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 3

    10 rows

    PolicyPayerEffective Date
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP])Cigna2026-10-15
    Metatarsophalangeal Joint ReplacementCigna2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15

    Related Codes

    CPT-42400-PERCUTANEOUS-SALIVARY-GLAND-BIOPSY

    CPT 42400: Percutaneous Needle Biopsy of Salivary Gland

    CPT-42405-SALIVARY-GLAND-BIOPSY-EXTERNAL-INCISION

    CPT 42405: Open Incisional Biopsy of Salivary Gland

    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 Lobe of Parotid Gland, No Nerve Dissection

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

    CPT 42415: Parotidectomy, Lateral Lobe Excision with Facial Nerve Preservation

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

    CPT 42425: Parotid Gland Removal with Tumor (Non–Nerve-Sparing)

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

    CPT 42426: Total Parotidectomy for Tumor with Unilateral Radical Neck Dissection

    CPT-42440-SUBMANDIBULAR-GLAND-EXCISION

    CPT 42440: Submandibular Gland Excision

    CPT-42450-SUBLINGUAL-GLAND-EXCISION

    CPT 42450: Excision of Sublingual Gland

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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