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

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 Washington, DC area, Medicare pays $535.95 for 15630 in the office and $349.05 when it’s performed in a hospital or facility.

$535.95Office (non-facility)
$349.05Hospital or facility
+14.0%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 Washington, DC area
  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 Washington, DC area 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. Washington, DC area pays $535.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

15630 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$535.95
  2. Los Angeles, CA · California$527.71−$8.24
  3. Miami, FL · Florida$510.61−$25.34
  4. Chicago, IL · Illinois$495.83−$40.12
  5. Manhattan, NY · New York$540.70+$4.75
  6. Alaska · Alaska$549.05+$13.10
  7. Alabama · Alabama$422.25−$113.70

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

15630 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$416.23$279.94
ArizonaArizona$457.47$303.73
Bakersfield, CACalifornia$496.05$322.16
Chico, CACalifornia$494.46$320.58
El Centro, CACalifornia$494.55$320.67
Fresno, CACalifornia$494.46$320.58
Hanford, CACalifornia$494.46$320.58
Madera, CACalifornia$494.46$320.58

15630 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 15630 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work3.98× 1.0544.1949
Practice expense9.55× 1.17811.2499
Malpractice0.54× 1.1130.6010
Total RVUs16.0458
Conversion factor× 33.4009

Office rate, Washington, DC area$535.95

Office: (3.98 × 1.054 + 9.55 × 1.178 + 0.54 × 1.113) × $33.4009 = $535.95

Facility: (3.98 × 1.054 + 4.8 × 1.178 + 0.54 × 1.113) × $33.4009 = $349.05

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

Codes related to 15630

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

Codes related to 15630
CodeHow it relatesOffice range, Washington, DC area
Same family
15600Flap delay, trunk siteFlap-delay code for the trunk region.$430.97
15610Flap delay, arms or legsFlap-delay code for the arms or legs.$450.04
15620Flap delay, face, neck, hand, foot, other sitesFlap-delay code for other listed regions, including scalp, neck, axilla, genitalia, hand, and foot.$529.71

How 15630 has changed in Washington, DC area

15630 · Office / nonfacility

$535.95

Effective 2026-10-01

The base rate is $15.17 higher than on 2025-10-01, moving from $520.78 to $535.95 (2.9%).

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

    $520.78changed to$535.95

    • 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 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $535.53changed to$520.78

    • 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

    $526.79changed to$535.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $549.07changed to$526.79

    • 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 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $560.57changed to$549.07

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $559.98changed to$560.57

    • 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

    $551.24changed to$559.98

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.45 changed to 8.95
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $546.21changed to$551.24

    • 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 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $543.44changed to$546.21

    • 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

    $542.89changed to$543.44

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.64 changed to 0.63
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $541.39changed to$542.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.31 changed to 8.33
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $543.72changed to$541.39

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.34 changed to 8.31
    • Malpractice RVU 0.62 changed to 0.64

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $541.02changed to$543.72

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $533.74changed to$541.02

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.21 changed to 8.34
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $546.00changed to$533.74

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.21 changed to 8.21
    • Malpractice RVU 0.65 changed to 0.62
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $546.00

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$535.95$349.05RVU26D
2026-07-01$535.95$349.05RVU26C
2026-04-01$535.95$349.05RVU26B
2026-01-01$535.95$349.05RVU26A
2025-10-01$520.78$385.44RVU25D
2025-07-01$520.78$385.44RVU25C
2025-04-01$520.78$385.44RVU25B
2025-01-01$520.78$385.44RVU25A
2024-10-01$535.53$393.08RVU24D
2024-07-01$535.53$393.08RVU24C
2024-04-01$535.53$393.08RVU24B
2024-03-09$535.53$393.08RVU24AR
2024-01-01$526.79$386.67RVU24A
2023-10-01$549.07$400.56RVU23D
2023-07-01$549.07$400.56RVU23C
2023-04-01$549.07$400.56RVU23B
2023-01-01$549.07$400.56RVU23A
2022-10-01$560.57$405.73RVU22D
2022-07-01$560.57$405.73RVU22C
2022-04-01$560.57$405.73RVU22B
2022-01-01$560.57$405.73RVU22A
2021-10-01$559.98$403.85RVU21D
2021-07-01$559.98$403.85RVU21C
2021-04-01$559.98$403.85RVU21B
2021-01-01$559.98$403.85RVU21A
2020-10-01$551.24$406.26RVU20D
2020-07-01$551.24$406.26RVU20C
2020-04-01$551.24$406.26RVU20B
2020-01-01$551.24$406.26RVU20A
2019-10-01$546.21$406.37RVU19D
2019-07-01$546.21$406.37RVU19C
2019-04-01$546.21$406.37RVU19B
2019-01-01$546.21$406.37RVU19A
2018-10-01$543.44$407.66RVU18D
2018-07-01$543.44$407.66RVU18C
2018-04-01$543.44$407.66RVU18B
2018-01-01$543.44$407.66RVU18AR1
2017-10-01$542.89$408.82RVU17D
2017-07-01$542.89$408.82RVU17C
2017-04-01$542.89$408.82RVU17B
2017-01-01$542.89$408.82RVU17A
2016-10-01$541.39$408.08RVU16D
2016-07-01$541.39$408.08RVU16C
2016-04-01$541.39$408.08RVU16B
2016-01-01$541.39$408.08RVU16A
2015-10-01$543.72$408.63RVU15D
2015-07-01$543.72$408.63RVU15C
2015-04-01$541.02$406.59RVU15B
2015-01-01$541.02$406.59RVU15A
2014-10-01$533.74$402.84RVU14D
2014-07-01$533.74$402.84RVU14C
2014-04-01$533.74$402.84RVU14B
2014-01-01$533.74$402.84RVU14A
2013-10-01$546.00$405.38RVU13D
2013-07-01$546.00$405.38RVU13C
2013-04-01$546.00$405.38RVU13B
2013-01-01$546.00$405.38RVU13AR

Price 15630 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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 Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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