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See a sample rate comparisonCPT 42440 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Exc Submandibular Gland
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $370.42 national non-facility rate (2026) · View Medicare rates for 42440 |
| Medicaid Fee Schedule | $340.53 median of the 8 states in the free preview · View Medicaid rates for 42440 |
National average reimbursement for CPT 42440 by major payers:
$589.72
$575.60
$629.86
$697.72
Compare published rates across providers.
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CPT 42440
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Southwest Fort Worth, LLC
Texas Health Surgery Center Southwest Fort Worth LLC
$8,238.00Published rateAria Health Bucks County Spu
Jefferson Health-Northeast
$4,530.00Published rateLewis & Clark Orthopaedic Institute LLC
Lewis & Clark Orthopaedic, LLC 401(K) Plan
$2,803.00Published rateMadison Avenue Surgery Center LLC
$1,680.00Published ratePiedmont Endoscopy Center, Inc.
$518.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 42440 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 42440 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 42440 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 42405-CPT | Moderate | Saliva Gland Biopsy, A Procedure To Remove A Sample Of Tissue From A Saliva Gland For Testing (Biopsy). The Sample May Be Taken In A Surgery Or With A Needle. |
| 42410-CPT | Moderate | Xcision Of Parotid Tumor/Parotid Gland; Lateral Lobe W/O Nerv, Excision Of Parotid Tumor Or Parotid Gland; Lateral Lobe Without Nerv |
| 42415-CPT | High | Excision Of Parotid Tumor Or P, Excision Of Parotid Tumor Or Parotid Gland Lateral Lobewith Dissection And Preservation Of Facial Nerve |
| 42440-CPT | Moderate | Exc Submandibular Gland |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 42440. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 42440 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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