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

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 Puerto Rico, Medicare pays $473.19 for 15630 in the office and $312.79 when it’s performed in a hospital or facility.

$473.19Office (non-facility)
$312.79Hospital or facility
+0.7%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $473.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

15630 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$473.19
  2. Los Angeles, CA · California$527.71+$54.52
  3. Washington, DC area · District of Columbia$535.95+$62.76
  4. Miami, FL · Florida$510.61+$37.42
  5. Chicago, IL · Illinois$495.83+$22.64
  6. Manhattan, NY · New York$540.70+$67.51
  7. Alaska · Alaska$549.05+$75.86

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

Every other payment area

15630 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$422.25$283.43
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

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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 15630 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.98× 1.0003.9800
Practice expense9.55× 1.0119.6550
Malpractice0.54× 0.9850.5319
Total RVUs14.1669
Conversion factor× 33.4009

Office rate, Puerto Rico$473.19

Office: (3.98 × 1 + 9.55 × 1.011 + 0.54 × 0.985) × $33.4009 = $473.19

Facility: (3.98 × 1 + 4.8 × 1.011 + 0.54 × 0.985) × $33.4009 = $312.79

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, Puerto Rico
Same family
15600Flap delay, trunk siteFlap-delay code for the trunk region.$376.49
15610Flap delay, arms or legsFlap-delay code for the arms or legs.$394.50
15620Flap delay, face, neck, hand, foot, other sitesFlap-delay code for other listed regions, including scalp, neck, axilla, genitalia, hand, and foot.$466.86

How 15630 has changed in Puerto Rico

15630 · Office / nonfacility

$473.19

Effective 2026-10-01

The base rate is $19.20 higher than on 2025-10-01, moving from $453.99 to $473.19 (4.2%).

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

    $453.99changed to$473.19

    • 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
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $466.86changed to$453.99

    • 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

    $459.24changed to$466.86

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $472.22changed to$459.24

    • 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
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $470.02changed to$472.22

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $475.64changed to$470.02

    • 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
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $475.39changed to$475.64

    • 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.

  8. January 1, 2021

    RVU21A

    $473.54changed to$475.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.45 changed to 8.95
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $473.64changed to$473.54

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $471.31changed to$473.64

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

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $417.08changed to$471.31

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.64 changed to 0.63
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $362.56changed to$417.08

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.31 changed to 8.33
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $364.41changed to$362.56

    • 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.

  14. July 1, 2015

    RVU15C

    $362.60changed to$364.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $355.70changed to$362.60

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.21 changed to 8.34
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $356.77changed to$355.70

    • 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
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $356.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$473.19$312.79RVU26D
2026-07-01$473.19$312.79RVU26C
2026-04-01$473.19$312.79RVU26B
2026-01-01$473.19$312.79RVU26A
2025-10-01$453.99$339.66RVU25D
2025-07-01$453.99$339.66RVU25C
2025-04-01$453.99$339.66RVU25B
2025-01-01$453.99$339.66RVU25A
2024-10-01$466.86$346.53RVU24D
2024-07-01$466.86$346.53RVU24C
2024-04-01$466.86$346.53RVU24B
2024-03-09$466.86$346.53RVU24AR
2024-01-01$459.24$340.87RVU24A
2023-10-01$472.22$348.91RVU23D
2023-07-01$470.02$347.68RVU23C
2023-04-01$470.02$347.68RVU23B
2023-01-01$470.02$347.68RVU23A
2022-10-01$475.64$349.37RVU22D
2022-07-01$475.64$349.37RVU22C
2022-04-01$475.64$349.37RVU22B
2022-01-01$475.64$349.37RVU22A
2021-10-01$475.39$348.07RVU21D
2021-07-01$475.39$348.07RVU21C
2021-04-01$475.39$348.07RVU21B
2021-01-01$475.39$348.07RVU21A
2020-10-01$473.54$353.86RVU20D
2020-07-01$473.54$353.86RVU20C
2020-04-01$473.54$353.86RVU20B
2020-01-01$473.54$353.86RVU20A
2019-10-01$473.64$356.78RVU19D
2019-07-01$473.64$356.78RVU19C
2019-04-01$473.64$356.78RVU19B
2019-01-01$473.64$356.78RVU19A
2018-10-01$471.31$357.84RVU18D
2018-07-01$471.31$357.84RVU18C
2018-04-01$471.31$357.84RVU18B
2018-01-01$471.31$357.84RVU18AR1
2017-10-01$417.08$321.84RVU17D
2017-07-01$417.08$321.84RVU17C
2017-04-01$417.08$321.84RVU17B
2017-01-01$417.08$321.84RVU17A
2016-10-01$362.56$284.56RVU16D
2016-07-01$362.56$284.56RVU16C
2016-04-01$362.56$284.56RVU16B
2016-01-01$362.56$284.56RVU16A
2015-10-01$364.41$285.38RVU15D
2015-07-01$364.41$285.38RVU15C
2015-04-01$362.60$283.96RVU15B
2015-01-01$362.60$283.96RVU15A
2014-10-01$355.70$280.34RVU14D
2014-07-01$355.70$280.34RVU14C
2014-04-01$355.70$280.34RVU14B
2014-01-01$355.70$280.34RVU14A
2013-10-01$356.77$277.19RVU13D
2013-07-01$356.77$277.19RVU13C
2013-04-01$356.77$277.19RVU13B
2013-01-01$356.77$277.19RVU13AR

Price 15630 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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