CPT code 30450: Nasal revision, major revision2026 Medicare rate & RVUs in California
Reports major revision rhinoplasty on a previously operated nose when the procedure includes both nasal tip work and osteotomies.
CMS doesn’t publish an office rate for 30450 in California.
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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On this page 9 sections
What 30450 covers
This code describes major secondary rhinoplasty: revision of a nose that has already undergone surgery, with work on both the nasal tip and nasal bones through osteotomies. A plastic surgeon, facial plastic surgeon, or otolaryngologist typically performs the operation in a surgical setting. The operative report should establish the prior nasal surgery and describe the tip work and osteotomies performed.
Choose this level based on the revision’s documented extent, not simply because it is a repeat operation. Medicare payment is restricted to specific circumstances, so the record must support the applicable coverage basis. The service 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 subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 30450 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 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,690.94 |
| Chico, CA | Unavailable | $1,680.98 |
| El Centro, CA | Unavailable | $1,681.58 |
| Fresno, CA | Unavailable | $1,680.98 |
| Hanford, CA | Unavailable | $1,680.98 |
| Los Angeles, CA | Unavailable | $1,788.26 |
| Madera, CA | Unavailable | $1,680.98 |
| Marin County, CA | Unavailable | $1,998.55 |
| Merced, CA | Unavailable | $1,680.98 |
| Modesto, CA | Unavailable | $1,680.98 |
| Napa, CA | Unavailable | $1,902.79 |
| Oxnard, CA | Unavailable | $1,774.18 |
| Redding, CA | Unavailable | $1,680.98 |
| Rest of California | Unavailable | $1,680.98 |
| Riverside, CA | Unavailable | $1,719.32 |
| Sacramento, CA | Unavailable | $1,752.21 |
| Salinas, CA | Unavailable | $1,745.48 |
| San Benito County, CA | Unavailable | $2,045.51 |
| San Diego, CA | Unavailable | $1,778.17 |
| San Francisco, CA | Unavailable | $1,994.50 |
| San Luis Obispo, CA | Unavailable | $1,718.89 |
| Santa Clara County, CA | Unavailable | $2,028.98 |
| Santa Cruz, CA | Unavailable | $1,788.44 |
| Santa Maria, CA | Unavailable | $1,749.73 |
| Santa Rosa, CA | Unavailable | $1,805.66 |
| Stockton, CA | Unavailable | $1,680.98 |
| Vallejo, CA | Unavailable | $1,896.96 |
| Visalia, CA | Unavailable | $1,680.98 |
| Yuba City, CA | Unavailable | $1,680.98 |
How the 30450 rate is calculated
Each of 30450’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 · 30450
RVUs × geographic indexes × conversion factor
Work19.17
19.17 RVUs× 1.000 GPCI
Practice expense26.39
26.39 RVUs× 1.000 GPCI
Malpractice3.56
3.56 RVUs× 1.000 GPCI
Adjusted RVUs
49.1200
Conversion factor
$33.4009
Medicare rate
$1,640.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 30450
30450 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 30450
Nasal revision, major revision
| 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 · 30450
Nasal revision, major revision
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
30450 without 51 · national facility
$1,640.65
Nasal revision, major revision
30450-51 · Second procedure: 50%
$820.33
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%).
30450 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 30430Nose revisionMinor secondary revision
- Use 30430 for a minor secondary revision with a small amount of nasal tip work. This code is for the major revision level, including both tip work and osteotomies.
- 30435Revision rhinoplastyIntermediate, osteotomies
- 30435 is the intermediate revision level, described as involving bony work and osteotomies. This code is the major level when the revision also includes nasal tip work.
- 30400Nasal reconstructionLateral or alar cartilage, or tip
- 30400 is a nasal reconstruction code, not the major secondary revision code for a previously operated nose with tip work and osteotomies.
30450 billing questions
What distinguishes this code from 30430?
This code represents a major revision with both nasal tip work and osteotomies. 30430 is for a minor revision involving a small amount of nasal tip work.
How does this differ from 30435?
30435 describes an intermediate revision with bony work and osteotomies. This code is the major revision level when the documented procedure includes both tip work and osteotomies.
What documentation supports the major revision level?
Document the history of prior nasal surgery and describe the revision performed, including both nasal tip work and osteotomies.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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
Show the CMS file lines behind this rate
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