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

CPT code 42425 denotes surgical excision of the parotid gland with a tumor removed as a single unit without preservation of the facial nerve. Nationally, this code is used for cases where tumor involvement or surgical planning precludes facial nerve-sparing approaches. It is relevant to surgical oncology, head and neck surgery, and facility billing for operative services.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, and common billing constructs tied to this code. The publication summarizes benchmark considerations for payment and utilization, highlights policy and coverage factors that commonly affect reimbursement, and situates the code within operative care pathways for parotid tumors.

This executive summary is intended for a national audience of payers, providers, and billing professionals seeking concise information on coding, clinical context, and payer coverage patterns for CPT code 42425. Data not available in the input are noted where applicable in the detailed sections.

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Billing Code Overview

CPT code 42425 describes the removal of the parotid gland with a tumor as a single unit without preservation of the facial nerve. This procedure is a surgical excision of the parotid gland performed when tumor involvement or operative planning necessitates removal of the gland en bloc without attempting to preserve the facial nerve.

Service type: Surgical resection of the parotid gland for tumor removal
Typical site of service: Inpatient or outpatient surgical setting, commonly performed in a hospital operating room or ambulatory surgical center depending on clinical complexity and institutional practice

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

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Billing Code Overview

Service type: Surgical resection of the parotid gland for tumor removal
Typical site of service: Inpatient or outpatient surgical setting, commonly performed in a hospital operating room or ambulatory surgical center depending on clinical complexity and institutional practice

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old with a progressively enlarging, firm, non-tender mass in the tail of the parotid gland with imaging (ultrasound/CT/MRI) suspicious for primary salivary gland malignancy. Fine needle aspiration may be indeterminate or suggest malignant neoplasm. The surgical team schedules a radical parotidectomy with removal of the parotid gland and tumor en bloc without preservation of the facial nerve due to tumor encasement or direct invasion of the facial nerve. The operative workflow includes preoperative imaging review, informed consent discussing facial nerve sacrifice and expected facial paralysis, general anesthesia with nerve monitoring as applicable, wide exposure of the parotid region, careful oncologic resection of the gland and tumor as a single specimen, hemostasis, possible neck dissection if nodal disease is suspected, placement of drains, and postoperative recovery with plans for adjuvant radiotherapy if pathology confirms malignancy. Typical site of service is an inpatient or ambulatory hospital surgical suite for major head and neck oncologic surgery. Service type: major surgical oncology procedure of the head and neck.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — standard reporting	Use when no specific modifier applies and standard global period and services are reported.
`11`	Professional component	Use if reporting only the physician’s professional portion when technical component is billed separately (rare for this operative service).
`22`	Increased procedural services	Use when the procedure required substantially greater effort or time than typically required (document justification).
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and an unusual anesthesia technique was required for medically necessary reasons.
`50`	Bilateral procedure	Use if both parotid glands are removed during the same operative session (rare).
`51`	Multiple procedures	Use when this procedure is billed with other distinct procedures during the same operative session (append modifier to secondary codes per payer rules).
`52`	Reduced services	Use when a lesser or partial procedure was performed than described by the CPT (document reason).
`53`	Discontinued procedure	Use if the procedure was started but terminated due to extenuating circumstances (document reason).
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons performing distinct portions of the procedure.
`78`	Return to the operating room for related procedure during postoperative period	Use when a related take-back operation for complications (e.g., hematoma evacuation) occurs during the global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period (not in the provided list but commonly considered; omitted per provided list).
`80`	Assistant surgeon	Use when an assistant surgeon participates and billing requires the assistant modifier.
`81`	Minimum assistant surgeon	Use when a minimum assistant surgeon provides limited assistance.
`82`	Assistant surgeon when qualified assistant not available	Use when an assistant who does not meet usual qualifications is used because a qualified assistant is not available (document).
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services in ambulatory surgical setting	Use when an advanced practice clinician performs or assists in the service per payer policy.

Taxonomy Code	Specialty	Notes
2080S00000X	Otolaryngology (ENT)	Primary specialty performing parotidectomy for benign and malignant disease.
2086P0800X	Oral and Maxillofacial Surgery	May perform parotid and adjacent facial reconstructive procedures, often for complex resections.
207K00000X	General Surgery	May perform head and neck oncologic resections in some centers.
2084P0800X	Plastic Surgery	Involved for facial nerve reconstruction and soft tissue reconstruction post-resection.
2083N0400X	Neurological Surgery	Occasionally involved for complex skull base or nerve reconstruction cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C07`	Malignant neoplasm of parotid gland	Primary malignant diagnosis indicating need for radical parotidectomy when facial nerve is involved.
`D11.0`	Benign neoplasm of parotid gland	Some large or deep benign tumors may require more extensive resection; rarely nerve sacrifice.
`C08.0`	Malignant neoplasm of submandibular gland	Related salivary gland malignancy; may prompt combined salivary gland surgeries.
`C09.0`	Malignant neoplasm of tonsil	Head and neck malignancies can coexist; relevant for staging and combined procedures.
`C80.1`	Malignant (primary) neoplasm, unspecified	Used when primary site is malignant but not otherwise specified; requires clarification from pathology.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`42425`	Radical parotidectomy — removal of parotid gland with tumor as a single unit without preservation of the facial nerve	Primary procedure when the facial nerve must be sacrificed for oncologic control.
`42415`	Partial parotidectomy (excision of parotid tumor, superficial lobe)	Often performed for benign or smaller superficial tumors as an alternative to radical parotidectomy.
`42420`	Total parotidectomy (removal of entire parotid gland with preservation of the facial nerve when possible)	Performed when nerve can be preserved; contrasts with `42425` where nerve is sacrificed.
`38571`	Biopsy or excision of lymph node(s); open, deep neck	Commonly performed concurrently or in staged fashion when nodal disease is suspected.
`42826`	Radical neck dissection including removal of internal jugular vein when indicated	May be performed in the same operative session for advanced regional nodal metastasis.
`69990`	Microscopy, surgical, includes use of operating microscope	May be used intraoperatively for nerve assessment or microsurgical reconstruction following tumor resection.

CPT 42400: Percutaneous Salivary Gland Biopsy

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

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-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

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
`00`	No modifier — standard reporting	Use when no specific modifier applies and standard global period and services are reported.
`11`	Professional component	Use if reporting only the physician’s professional portion when technical component is billed separately (rare for this operative service).
`22`	Increased procedural services	Use when the procedure required substantially greater effort or time than typically required (document justification).
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and an unusual anesthesia technique was required for medically necessary reasons.
`50`	Bilateral procedure	Use if both parotid glands are removed during the same operative session (rare).
`51`	Multiple procedures	Use when this procedure is billed with other distinct procedures during the same operative session (append modifier to secondary codes per payer rules).
`52`	Reduced services	Use when a lesser or partial procedure was performed than described by the CPT (document reason).
`53`	Discontinued procedure	Use if the procedure was started but terminated due to extenuating circumstances (document reason).
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons performing distinct portions of the procedure.
`78`	Return to the operating room for related procedure during postoperative period	Use when a related take-back operation for complications (e.g., hematoma evacuation) occurs during the global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period (not in the provided list but commonly considered; omitted per provided list).
`80`	Assistant surgeon	Use when an assistant surgeon participates and billing requires the assistant modifier.
`81`	Minimum assistant surgeon	Use when a minimum assistant surgeon provides limited assistance.
`82`	Assistant surgeon when qualified assistant not available	Use when an assistant who does not meet usual qualifications is used because a qualified assistant is not available (document).
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services in ambulatory surgical setting	Use when an advanced practice clinician performs or assists in the service per payer policy.

Taxonomy Code	Specialty	Notes
2080S00000X	Otolaryngology (ENT)	Primary specialty performing parotidectomy for benign and malignant disease.
2086P0800X	Oral and Maxillofacial Surgery	May perform parotid and adjacent facial reconstructive procedures, often for complex resections.
207K00000X	General Surgery	May perform head and neck oncologic resections in some centers.
2084P0800X	Plastic Surgery	Involved for facial nerve reconstruction and soft tissue reconstruction post-resection.
2083N0400X	Neurological Surgery	Occasionally involved for complex skull base or nerve reconstruction cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C07`	Malignant neoplasm of parotid gland	Primary malignant diagnosis indicating need for radical parotidectomy when facial nerve is involved.
`D11.0`	Benign neoplasm of parotid gland	Some large or deep benign tumors may require more extensive resection; rarely nerve sacrifice.
`C08.0`	Malignant neoplasm of submandibular gland	Related salivary gland malignancy; may prompt combined salivary gland surgeries.
`C09.0`	Malignant neoplasm of tonsil	Head and neck malignancies can coexist; relevant for staging and combined procedures.
`C80.1`	Malignant (primary) neoplasm, unspecified	Used when primary site is malignant but not otherwise specified; requires clarification from pathology.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`42425`	Radical parotidectomy — removal of parotid gland with tumor as a single unit without preservation of the facial nerve	Primary procedure when the facial nerve must be sacrificed for oncologic control.
`42415`	Partial parotidectomy (excision of parotid tumor, superficial lobe)	Often performed for benign or smaller superficial tumors as an alternative to radical parotidectomy.
`42420`	Total parotidectomy (removal of entire parotid gland with preservation of the facial nerve when possible)	Performed when nerve can be preserved; contrasts with `42425` where nerve is sacrificed.
`38571`	Biopsy or excision of lymph node(s); open, deep neck	Commonly performed concurrently or in staged fashion when nodal disease is suspected.
`42826`	Radical neck dissection including removal of internal jugular vein when indicated	May be performed in the same operative session for advanced regional nodal metastasis.
`69990`	Microscopy, surgical, includes use of operating microscope	May be used intraoperatively for nerve assessment or microsurgical reconstruction following tumor resection.

CPT 42400: Percutaneous Salivary Gland Biopsy

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

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-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

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

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Billing Code Overview

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

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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