CPT code 30100: Nasal biopsy, intranasal tissue sampling2026 Medicare rate & RVUs in California

Reports sampling of tissue inside the nose for diagnostic evaluation, such as an abnormal mucosal area or intranasal lesion requiring histopathologic examination.

CMS RVU26DEffective Oct 1, 202629 payment localities1.6K Medicare services in 2024

Medicare pays $149.99–$189.60 for 30100 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.

$149.99–$189.60Office (non-facility)
$62.13–$74.00Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What 30100 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 30100 covers

An otolaryngologist typically obtains a small tissue sample from inside the nose when examination identifies abnormal mucosa or a lesion that needs diagnostic evaluation. The clinician may use biopsy forceps through the nostril, often in an office setting, and submit the specimen for pathologic examination. The service is tissue sampling, not removal of an entire polyp or therapeutic excision of a lesion.

Report 30100 when tissue is sampled for diagnosis; document the intranasal site, the abnormal finding, the sampling performed, and specimen submission. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Do not use modifier 50; CMS bilateral adjustment does not apply. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing 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 30100 pays more and less in California

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

29 payment localities

$149.99 to $189.60

$149.99$169.80$189.60
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

29 of 29 payment localities

30100 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CA$150.37$62.51
Chico, CA$149.99$62.13
El Centro, CA$150.01$62.15
Fresno, CA$149.99$62.13
Hanford, CA$149.99$62.13
Los Angeles, CA$160.52$65.69
Madera, CA$149.99$62.13
Marin County, CA$185.40$72.38
Merced, CA$149.99$62.13
Modesto, CA$149.99$62.13

How the 30100 rate is calculated

Each of 30100’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 · 30100

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.92

0.92 RVUs× 1.000 GPCI

Practice expense3.18

3.18 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

4.2300

Conversion factor

$33.4009

Medicare rate

$141.29

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

Payment rules and modifiers for 30100

The CMS indicators that decide how 30100 is paid alongside other services.

CMS payment indicators · 30100

Nasal biopsy, intranasal tissue sampling

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

30100 without 51 · national office

$141.29

Nasal biopsy, intranasal tissue sampling

30100-51 · Second procedure: 50%

$70.65

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

30100 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 30100

    Nasal biopsy, intranasal tissue sampling0.92 wRVU

    $141.29

  • 30117

    Intranasal lesion removal, internal approach3.81 wRVU

    $951.59+$810.30

  • 30118

    Nasal lesion removal, external approach7.56 wRVU

    Not priced

  • 30110

    Nasal polypectomy, simple removal1.64 wRVU

    $246.83+$105.54

  • 30115

    Nasal polypectomy, extensive removal4.33 wRVU

    Not priced

How to choose

30117Intranasal lesion removalInternal approach
30100 reports tissue sampling for diagnosis. Use 30117 when the intranasal lesion is removed rather than sampled.
30118Nasal lesion removalExternal approach
30118 is for extensive intranasal lesion removal; 30100 is for taking a diagnostic tissue sample.
30110Nasal polypectomySimple removal
30110 reports removal of nasal polyp tissue. 30100 applies when tissue is sampled for diagnostic evaluation.
30115Nasal polypectomyExtensive removal
30115 reports extensive nasal polyp removal, not an intranasal biopsy.

30100 billing questions

When should 30100 be used instead of an intranasal lesion excision code?

Use 30100 when tissue is sampled for diagnosis. When the service removes or excises the lesion rather than taking a diagnostic sample, consider the applicable lesion-removal code.

Is removal of a nasal polyp reported as 30100?

Not when the service is removal of the polyp. Codes 30110 and 30115 describe nasal polyp removal; 30100 is for intranasal tissue sampling.

Can modifier 50 be appended for biopsies on both sides?

No. CMS bilateral adjustment does not apply to 30100, and modifier 50 is inappropriate for this code.

What documentation supports reporting 30100?

Document the intranasal site and abnormal finding, the tissue sampling performed, and the specimen submitted for diagnostic evaluation.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50% when performed in the same session.

Can an assistant surgeon or co-surgeon be billed for 30100?

Medicare does not pay an assistant at surgery for this code. 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 30100PPRRVU2026_Oct_nonQPP.csv, line 3,394 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 30100 pays in California?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 30100 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist