CPT code 30435: Revision rhinoplasty, intermediate, osteotomies2026 Medicare rate & RVUs in Missouri
Reports an intermediate revision of a previously operated nose when the surgeon performs bony reshaping with osteotomies during secondary rhinoplasty.
CMS doesn’t publish an office rate for 30435 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 30435 covers
This service is an intermediate revision of a nose that has already undergone surgery, with bony reshaping that includes osteotomies. It is typically performed by an otolaryngologist or plastic surgeon in an operating-room setting. The operative work distinguishes this level from a limited revision focused on a small amount of nasal tip work and from a major revision that combines tip work with osteotomies.
Select the code based on the documented revision work, not simply the fact that the patient had prior nasal surgery. The operative report should establish the prior surgery and describe the bony work and osteotomies performed. Medicare payment is restricted to specific circumstances, so the record must support the applicable covered circumstance. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 30435 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,240.10 |
| Metropolitan St. Louis, MO | Unavailable | $1,252.42 |
| Rest of Missouri | Unavailable | $1,178.35 |
How the 30435 rate is calculated
Each of 30435’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 · 30435
RVUs × geographic indexes × conversion factor
Work12.41
12.41 RVUs× 1.000 GPCI
Practice expense23.92
23.92 RVUs× 1.000 GPCI
Malpractice2.31
2.31 RVUs× 1.000 GPCI
Adjusted RVUs
38.6400
Conversion factor
$33.4009
Medicare rate
$1,290.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 30435
30435 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 30435
Revision rhinoplasty, intermediate, osteotomies
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 30435
Revision rhinoplasty, intermediate, osteotomies
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
30435 without 51 · national facility
$1,290.61
Revision rhinoplasty, intermediate, osteotomies
30435-51 · Second procedure: 50%
$645.31
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%).
30435 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 30430Nose revisionMinor secondary revision
- Choose 30430 for a minor revision involving a small amount of tip work. Choose 30435 when the revision includes bony work with osteotomies.
- 30450Nasal revisionMajor revision
- Choose 30450 for a major secondary revision combining tip work and osteotomies. 30435 is the intermediate revision level with bony work and osteotomies.
- 30400Nasal reconstructionLateral or alar cartilage, or tip
- 30400 is for primary rhinoplasty. Use 30435 when the nose has been operated on previously and the current procedure is an intermediate revision with osteotomies.
30435 billing questions
How does 30435 differ from 30430?
30435 represents an intermediate revision involving bony work with osteotomies. 30430 is for a minor revision involving a small amount of nasal tip work.
How does 30435 differ from 30450?
30435 describes an intermediate revision with bony work and osteotomies. 30450 is the major revision level, combining nasal tip work and osteotomies.
What documentation supports 30435?
Document the prior nasal operation and the current revision work, including the bony reshaping and osteotomies. The record should also support the specific circumstance for which Medicare coverage is available.
Should modifier 50 be reported for work on both sides of the nose?
No. The bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted under the CMS rules provided for this code.
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
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