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Billing code 30540: Choanal atresia repairMedicare rate & RVUs

Reports surgical correction of congenital choanal blockage through an intranasal approach, commonly restoring posterior nasal airflow in an affected infant.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $672.69 for 30540 nationally in a facility.

Medicare rate · 30540

Choanal atresia repair

Swap in your local Medicare rate.

Work RVUs
7.72
Total RVUs
20.14
Global days
090

National rate · 2026

$672.69

Facility setting, before claim adjustments.

See every locality for 30540 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 30540 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 30540 covers

This operation opens a congenital obstruction at the back of the nasal passage using an intranasal route. Choanal atresia may present in a newborn or infant with impaired nasal breathing or feeding; the surgeon removes or reshapes the obstructing tissue to establish an airway. An otolaryngologist typically performs the repair in an operating room, with the operative report identifying the atresia and documenting the intranasal approach and work performed.

Choose 30540 when the repair is performed intranasally; the transpalatal approach is represented by 30545. The documentation should support the diagnosis, surgical route, and repair rather than a separate procedure for another nasal condition. CMS assigns 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 others are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this code.

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 30540 pays more and less

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

109 of 109 payment localities

30540 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$609.18
Alaska*Unavailable$809.19
ArizonaUnavailable$655.57
ArkansasUnavailable$601.22
AtlantaUnavailable$687.09
AustinUnavailable$690.78
BakersfieldUnavailable$699.04
Baltimore/Surr. CntysUnavailable$713.29
BeaumontUnavailable$636.08
BrazoriaUnavailable$663.06

30540 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
30540 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 30540 rate is calculated

Each of 30540’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 · 30540

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.72Practice expense 11.29Malpractice 1.13

20.1400 adjusted RVUs×$33.4009 conversion factor=$672.69

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 30540

30540 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 30540

Choanal atresia repair

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)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.76/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 30540

Choanal atresia repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

30540 without 51 · national facility

$672.69

Choanal atresia repair

30540-51 · Second procedure: 50%

$336.35

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

30540 compared with similar codes

Compare codes

30540 vs 30545 vs 30560 vs 30520: national Medicare rates

Swap in your local Medicare rate.

  • 30540
    Choanal atresia repair · 7.72 wRVU
    —
  • 30545
    Choanal repair · 11.33 wRVU
    —
  • 30560
    Nasal adhesion lysis · 1.28 wRVU
    $315.30
  • 30520
    Septoplasty · 6.83 wRVU
    —

How to choose

30545Choanal repair
Both codes address choanal atresia, but 30540 is for an intranasal repair and 30545 is for a transpalatal repair. Follow the documented operative route.
30560Nasal adhesion lysis
30560 is for releasing intranasal adhesions. It is not the code for repairing congenital blockage of the posterior nasal passage.
30520Septoplasty
30520 addresses repair of the nasal septum. It does not represent correction of choanal atresia.

Codes related to 30540

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

Codes related to 30540
CodeHow it relatesNational office range
Same family
30545Choanal repairRepairs choanal atresia through a transpalatal approach rather than the intranasal route.No office rate
Used instead
30560Nasal adhesion lysisTreats intranasal synechiae causing obstruction, not congenital choanal atresia.$274.69–$434.73
30520SeptoplastyRepairs a nasal septal problem when that, rather than choanal atresia, is the condition treated.No office rate

30540 billing questions

How do I choose 30540 instead of 30545?

Use 30540 when the choanal atresia repair is performed through an intranasal approach. The transpalatal approach is reported with 30545.

What documentation supports 30540?

The operative report should identify choanal atresia, describe the intranasal route, and document the repair performed to establish the nasal airway.

Can modifier 50 be reported for repair on both sides?

No. CMS identifies bilateral adjustment as inappropriate for 30540; modifier 50 should not be used.

How does CMS pay 30540 with another procedure in the same session?

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

Can an assistant or another surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 30540PPRRVU2026_Oct_nonQPP.csv, line 3,450 (RVU26D)

Open CMS sourceHow we calculate rates

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