CPT 42408 Surgery - Digestive

How Much Does Excision of Salivary Cyst Cost?

Also known as: Excision of salivary cyst (CPT 42408)

Excision of Salivary Cyst (CPT 42408) costs $324 at Medicare rates. Hospital outpatient rate: $3.

Cost Comparison by Payer

How much Excision of salivary cyst costs across different settings and payers

Medicare
Facility rate
$324
Hospital Outpatient
OPPS rate
$3
Surgery Center
ASC rate
$1
Medicare (Facility)
$324
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$570
Non-facility setting
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$1
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside Excision of salivary cyst

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How to Reduce Your Cost for Excision of salivary cyst

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($570) differs from the facility rate ($324). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $1, compared to $3 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

4.54
Work RVU
4.52
Practice Expense RVU
0.65
Malpractice RVU
17.07
Total RVU

Payment = Total RVU (17.07) x CF ($33.40) = $570

Frequently Asked Questions

How much does Excision of salivary cyst cost?

The Medicare facility rate for Excision of salivary cyst is $324. In a hospital outpatient setting, the rate is $3. At an ambulatory surgery center, the rate is $1. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Excision of salivary cyst cost without insurance?

Without insurance, the cost of Excision of salivary cyst can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Excision of salivary cyst?

Most commercial health insurance plans and Medicare cover Excision of salivary cyst when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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