Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 42510 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.
Parotid Duct Diversion, Creation Of New Drainage Tracts Of Major Salivary Gland Ducts On Both Sides Of Mouth With Tying Of Salivary Gland Ducts
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | AS - PA/NP/CNS assistant at surgery 52 - Reduced Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $537.42 national non-facility rate (2026) · View Medicare rates for 42510 |
| Medicaid Fee Schedule | $484.665 median of the 8 states in the free preview · View Medicaid rates for 42510 |
National average reimbursement for CPT 42510 by major payers:
$792.48
$833.39
$858.96
$1,010.36
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 42510.
CPT 42510
5 of 25 sample ratesHigher to lower in this preview
Princess Anne Ambulatory Surgery Management LLC, Princess Anne Ambulatory Surgery Center
Princess Anne Ambulatory Surgery Management, LLC
$9,251.00Published rateTamarac Surgery Center LLC, The Surgery Center Of Ft Lauderdale
Tamarac Surgery Center LLC
$5,249.00Published rateThe Surgery Center, LLC
The Surgery Center LLC
$3,077.00Published rateJ C Pitts Enterprises Inc, Ontario Surgery Center
J C Pitts Enterprises Inc
$2,108.00Published rateSight Partners Physicians, P.C., The Harman Eye Clinic
Sight Partners, LLC
$793.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 42510 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 42510 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 42510 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 |
|---|---|---|
| 42500-CPT | Moderate | Plastic Repair Of Salivary Duc, Plastic Repair Of Salivary Duct Sialodochoplastyprimaryor Simple Plastic Repair Of Salivary Duct Sialodochoplasty Primary |
| 42505-CPT | Moderate | Plastic Repair Of Salivary Duc, Plastic Repair Of Salivary Duct Sialodochoplastysecondaryor Complicated Plastic Repair Of Saliva Ry Duct Sialodochoplasty Secondary |
| 42509-CPT | High | Bypass Blockage In Saliva Duct, Surgery To Reposition The Parotid Gland To Bypass A Blockage And Allow Saliva To Flow Freely Into The Mouth. |
| 42510-CPT | Moderate | Parotid Duct Diversion, Creation Of New Drainage Tracts Of Major Salivary Gland Ducts On Both Sides Of Mouth With Tying Of Salivary Gland Ducts |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 42510. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 42510 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 42510) and we'll show you how you compare in 15 minutes or less.