2025 CPT code 42408
Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Excision of sublingual salivary cyst (ranula).
Modifiers may be applicable to this code to indicate specific circumstances of the procedure, such as increased procedural services (22), multiple procedures (51), or reduced services (52). Refer to current CPT guidelines for appropriate modifier usage.
Medical necessity for this procedure is established by the presence of a symptomatic ranula interfering with speech, swallowing, or causing discomfort. Documentation should clearly demonstrate the functional impairment caused by the lesion.
The physician performs a sharp incision to access the ranula under the tongue, removes the cyst, and sutures the site. They also typically remove the associated sublingual salivary gland.
In simple words: Removal of a large mucous cyst (called a ranula) under the tongue. The surgeon makes a cut inside the mouth to remove the cyst and usually the gland it comes from to stop it from coming back.
Surgical excision of a ranula, a type of mucous retention cyst, located beneath the tongue in the floor of the mouth. This procedure involves incising the overlying mucosa, carefully dissecting and removing the cyst, and typically includes removal of the associated sublingual salivary gland to prevent recurrence. The procedure inherently includes wound closure.
Example 1: A patient presents with a large, fluctuant swelling beneath the tongue, diagnosed as a ranula. The surgeon performs a transoral excision of the ranula and the sublingual gland., A patient has a recurrent ranula after previous marsupialization. The surgeon performs excision of the ranula along with the sublingual gland to minimize the risk of recurrence. , A patient has a plunging ranula extending into the neck. The surgeon performs a combined transoral approach to remove the sublingual gland and a cervical approach to excise the plunging portion of the cyst.
Documentation should include the diagnosis of ranula, size and location of the cyst, surgical approach used, whether the sublingual gland was removed, and method of wound closure.
** Excision of the sublingual gland is considered the standard of care for ranulas due to the high recurrence rate with other methods like marsupialization. While complete removal of the cyst is the goal, the critical component for preventing recurrence is removal of the sublingual gland.
- Specialties:Otolaryngology, Oral and Maxillofacial Surgery
- Place of Service:Office, Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital (if required for complex cases or plunging ranulas)