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

Reports a staged flap delay or pedicle sectioning involving the eyelid, nose, ear, or lip during reconstructive surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality5.2K Medicare services in 2024

In Vallejo, CA, Medicare pays $570.00 for 15630 in the office and $360.90 when it’s performed in a hospital or facility.

$570.00Office (non-facility)
$360.90Hospital or facility
+21.3%vs the national office rate ($469.95)

Check a contract rate as a % of Medicare · 15630 nationwide

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

We’ll open 15630 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vallejo, CA
  2. What 15630 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Vallejo, CA compares for 15630

Across 109 of 109 payment localities, the office rate for 15630 runs from $416.23 in Arkansas to $617.19 in San Benito County, CA. Vallejo, CA pays $570.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

15630 in Vallejo, CA vs other payment areas
  1. Vallejo, CA · this page$570.00
  2. Bakersfield, CA · California$496.05−$73.95
  3. Chico, CA · California$494.46−$75.54
  4. El Centro, CA · California$494.55−$75.45
  5. Fresno, CA · California$494.46−$75.54
  6. Hanford, CA · California$494.46−$75.54
  7. Los Angeles, CA · California$527.71−$42.29

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

15630 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$494.46$320.58
Merced, CACalifornia$494.46$320.58
Modesto, CACalifornia$494.46$320.58
Napa, CACalifornia$570.89$361.78
Oxnard, CACalifornia$524.93$337.40
Redding, CACalifornia$494.46$320.58
Rest of CaliforniaCalifornia$494.46$320.58
Riverside, CACalifornia$500.31$326.43

15630 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$416.23

$555.83

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
15630 office rate range by state
State / territoryOffice rate rangeLocalities
AK$549.051
AL$422.251
AR$416.231
AZ$457.471
CA$494.46–$617.1929
CO$488.011
CT$500.961
DC$535.951
DE$464.971
FL$464.99–$510.613
GA$438.96–$479.082
GU$506.061
HI$506.061
IA$431.961
ID$434.931
IL$452.35–$495.834
IN$437.391
KS$430.381
KY$433.011
LA$432.51–$453.582
MA$485.32–$535.302
MD$473.63–$535.953
ME$437.61–$460.422
MI$444.53–$471.162
MN$466.501
MO$425.46–$454.683
MS$420.911
MT$469.911
NC$442.071
ND$459.241
NE$434.171
NH$480.771
NJ$506.36–$530.592
NM$447.101
NV$467.261
NY$448.64–$554.205
OH$442.341
OK$431.801
OR$463.32–$502.872
PA$442.80–$488.902
PR$473.191
RI$481.051
SC$443.001
SD$457.971
TN$432.571
TX$439.96–$486.668
UT$448.971
VA$459.23–$535.952
VI$473.191
VT$457.851
WA$484.27–$545.702
WI$444.071
WV$435.941
WY$465.261

See 15630 in every payment locality

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.

How the rate is built · 15630

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.98

3.98 RVUs× 1.000 GPCI

Practice expense9.55

9.55 RVUs× 1.000 GPCI

Malpractice0.54

0.54 RVUs× 1.000 GPCI

Adjusted RVUs

14.0700

Conversion factor

$33.4009

Medicare rate

$469.95

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vallejo, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,527

Code
15630
Physician work
3.98
Practice expense
9.55
Malpractice
0.54

GPCI2026.csv

33

Locality
Vallejo, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.459
Office calculation for 15630 in Vallejo, CA
ComponentRVULocality factorAdjusted
Physician work3.98× 1.0634.2307
Practice expense9.55× 1.31812.5869
Malpractice0.54× 0.4590.2479
Total RVUs17.0655
Conversion factor× 33.4009

Office rate, Vallejo, CA$570.00

Office: (3.98 × 1.063 + 9.55 × 1.318 + 0.54 × 0.459) × $33.4009 = $570.00

Facility: (3.98 × 1.063 + 4.8 × 1.318 + 0.54 × 0.459) × $33.4009 = $360.90

Open 15630 in the RVU calculator

Payment rules and modifiers for 15630

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

CMS payment indicators · 15630

Flap staging, eyelid, nose, ear, or lip

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 15630

Flap staging, eyelid, nose, ear, or lip

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

15630 without 51 · national office

$469.95

Flap staging, eyelid, nose, ear, or lip

15630-51 · Second procedure: 50%

$234.98

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 15630 has changed in Vallejo, CA

15630 · Office / nonfacility

$570.00

Effective 2026-10-01

The base rate is $26.09 higher than on 2025-10-01, moving from $543.91 to $570.00 (4.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $543.91changed to$570.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.08 changed to 3.98
    • Practice expense RVU 9.34 changed to 9.55
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $559.30changed to$543.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.33 changed to 9.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $550.17changed to$559.30

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $550.48changed to$550.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.24 changed to 9.33
    • Malpractice RVU 0.55 changed to 0.56
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.265 changed to 1.310
    • Malpractice GPCI 0.487 changed to 0.470
  5. January 1, 2023

    RVU23A

    $538.84changed to$550.48

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.04 changed to 9.24
    • Malpractice RVU 0.56 changed to 0.55
    • Work GPCI 1.044 changed to 1.051
    • Practice expense GPCI 1.220 changed to 1.265
    • Malpractice GPCI 0.504 changed to 0.487

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $538.95changed to$538.84

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.95 changed to 9.04
    • Malpractice RVU 0.53 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $541.48changed to$538.95

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.45 changed to 8.95
    • Work GPCI 1.049 changed to 1.044
    • Practice expense GPCI 1.238 changed to 1.220
    • Malpractice GPCI 0.496 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $544.85changed to$541.48

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.38 changed to 8.45
    • Malpractice RVU 0.63 changed to 0.53
    • Work GPCI 1.055 changed to 1.049
    • Practice expense GPCI 1.256 changed to 1.238
    • Malpractice GPCI 0.458 changed to 0.496

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $541.99changed to$544.85

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.33 changed to 8.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $545.70changed to$541.99

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.64 changed to 0.63
    • Work GPCI 1.057 changed to 1.055
    • Practice expense GPCI 1.271 changed to 1.256
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$545.70

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$570.00$360.90RVU26D
2026-07-01$570.00$360.90RVU26C
2026-04-01$570.00$360.90RVU26B
2026-01-01$570.00$360.90RVU26A
2025-10-01$543.91$395.18RVU25D
2025-07-01$543.91$395.18RVU25C
2025-04-01$543.91$395.18RVU25B
2025-01-01$543.91$395.18RVU25A
2024-10-01$559.30$402.75RVU24D
2024-07-01$559.30$402.75RVU24C
2024-04-01$559.30$402.75RVU24B
2024-03-09$559.30$402.75RVU24AR
2024-01-01$550.17$396.18RVU24A
2023-10-01$550.48$395.73RVU23D
2023-07-01$550.48$395.73RVU23C
2023-04-01$550.48$395.73RVU23B
2023-01-01$550.48$395.73RVU23A
2022-10-01$538.84$386.00RVU22D
2022-07-01$538.84$386.00RVU22C
2022-04-01$538.84$386.00RVU22B
2022-01-01$538.84$386.00RVU22A
2021-10-01$538.95$384.84RVU21D
2021-07-01$538.95$384.84RVU21C
2021-04-01$538.95$384.84RVU21B
2021-01-01$538.95$384.84RVU21A
2020-10-01$541.48$394.49RVU20D
2020-07-01$541.48$394.49RVU20C
2020-04-01$541.48$394.49RVU20B
2020-01-01$541.48$394.49RVU20A
2019-10-01$544.85$399.09RVU19D
2019-07-01$544.85$399.09RVU19C
2019-04-01$544.85$399.09RVU19B
2019-01-01$544.85$399.09RVU19A
2018-10-01$541.99$400.46RVU18D
2018-07-01$541.99$400.46RVU18C
2018-04-01$541.99$400.46RVU18B
2018-01-01$541.99$400.46RVU18AR1
2017-10-01$545.70$404.29RVU17D
2017-07-01$545.70$404.29RVU17C
2017-04-01$545.70$404.29RVU17B
2017-01-01$545.70$404.29RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 15630 for an earlier date of service

Where the Vallejo, CA rate applies

Vallejo, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Vallejo
  • Allendale
  • Benicia
  • Dixon
  • Elmira
  • Fairfield
  • Green Valley
  • Hartley

Browse all communities in California

15630 billing questions

How does 15630 differ from other flap-delay codes?

Use 15630 for delay or sectioning at the eyelid, nose, ear, or lip. Codes 15600, 15610, and 15620 identify other anatomic regions.

Does 15630 describe the original flap transfer?

No. It describes a flap-delay or sectioning stage. The operative report should distinguish that work from the earlier creation or transfer of the flap.

Are routine postoperative visits separately included?

Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.

Should modifier 50 be appended for work on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 15630. Co-surgeons and team surgery are not permitted.

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

Show the CMS file lines behind this rate
RVUs for 15630PPRRVU2026_Oct_nonQPP.csv, line 1,527 (RVU26D)
Geographic factors for Vallejo, CAGPCI2026.csv, line 33 (RVU26D)

Open CMS sourceHow we calculate rates

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