CPT code 15630: Flap staging, eyelid, nose, ear, or lip2026 Medicare rate & RVUs

Medicare pays $469.95 for 15630 nationally in the office and $311.30 in a hospital or facility. Local office rates run $416.23–$617.19.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 15630 covers

Code 15630 covers a surgical stage that delays a flap or divides or sections its pedicle at the eyelid, nose, ear, or lip. In staged reconstruction, a surgeon may return to divide a previously transferred flap after it has developed blood supply from recipient tissues; nasal reconstruction with a staged forehead flap is a common example. Plastic and reconstructive surgeons, facial plastic surgeons, and oculoplastic surgeons may perform this work in an operating room or other surgical setting.

Report the code for the delay or sectioning stage, not for the original flap creation or transfer. The operative report should identify the flap, site, and work performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 15630 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

15630 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 15630 rate is calculated

Each of 15630’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 15630

15630 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

15630 compared with similar codes

How to choose

15620Flap delayFace, neck, hand, foot, other sites

15630 identifies work at the eyelid, nose, ear, or lip. Select 15620 for the other regions named in that code’s descriptor.

15610Flap delayArms or legs

15610 identifies flap delay or sectioning on the arms or legs; 15630 is for the specified eyelid, nose, ear, and lip sites.

15650Pedicle flap transferDistant donor-to-recipient transfer

15650 describes transfer of a skin pedicle flap. Use 15630 for flap delay or pedicle sectioning rather than the transfer itself.

Codes related to 15630

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates