Billing code 15630: Flap stagingMedicare rate & RVUs in Guam
Reports a staged flap delay or pedicle sectioning involving the eyelid, nose, ear, or lip during reconstructive surgery.
Medicare pays $506.06 for 15630 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
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.
15630 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $506.06 | $325.67 |
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
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.
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
| 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) | 1 | Not paid (statutory restriction). |
| 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) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 15630
Flap staging
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
15630 without 51 · national office
$469.95
Flap staging
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%).
15630 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15620Flap delay
- 15630 identifies work at the eyelid, nose, ear, or lip. Select 15620 for the other regions named in that code’s descriptor.
- 15610Flap delay
- 15610 identifies flap delay or sectioning on the arms or legs; 15630 is for the specified eyelid, nose, ear, and lip sites.
- 15650Pedicle flap transfer
- 15650 describes transfer of a skin pedicle flap. Use 15630 for flap delay or pedicle sectioning rather than the transfer itself.
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
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