No office rate
30540 repairs choanal atresia through an intranasal approach. Code 30580 closes an opening between the mouth and maxillary sinus.
On this page
CMS RVU26D · Effective 2026-10-01
30580 Fistula repair Medicare reimbursement rates in Hawaii
Repair an abnormal opening between the upper jaw and maxillary sinus, commonly after a dental extraction or infection, by surgically closing the communication. Compare 30580 office and facility rates across CMS payment localities in Hawaii.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 30580 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$664.57
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$430.64
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Otolaryngology surgery
About 30580: Oroantral fistula closure
Repair an abnormal opening between the upper jaw and maxillary sinus, commonly after a dental extraction or infection, by surgically closing the communication.
This service closes an oroantral fistula, an abnormal passage connecting the mouth and maxillary sinus. It is commonly needed after an upper tooth extraction or when infection or tissue breakdown leaves a persistent opening. An oral and maxillofacial surgeon or otolaryngologist may close the defect using adjacent tissue, often in an operating room or procedure setting. The repair addresses the communication itself; treatment of coexisting sinus disease may involve a separate sinus procedure.
Report 30580 for the surgical closure of the fistula, supported by documentation identifying the oral-to-sinus communication and the repair performed. It has a 90-day global period, including the day before surgery and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery reporting is not permitted.
CMS billing rules for 30580
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.71 · 36%
- Practice expense (office) RVU11.16 · 60%
- Malpractice RVU0.86 · 5%
719
Medicare services in 2024 · #3236 by national volume
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.
30580 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
30545 repairs choanal atresia through a transpalatal approach; 30580 treats an oroantral fistula, not a blocked nasal passage.
No office rate
30520 is septal surgery. Report 30580 when the operative target is the communication between the oral cavity and maxillary sinus.
Compare 30580 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$664.57
Facility
$430.64
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 30580 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,455
- Code
- 30580
- Physician work
- 6.71
- Practice expense
- 11.16
- Malpractice
- 0.86
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.71 | × 1.000 | 6.7100 |
| Practice expense | 11.16 | × 1.137 | 12.6889 |
| Malpractice | 0.86 | × 0.579 | 0.4979 |
| Total RVUs | 19.8969 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$664.57
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.71 | 1 |
| Practice expense | 11.16 | 1.137 |
| Malpractice | 0.86 | 0.579 |
(6.71 × 1 + 11.16 × 1.137 + 0.86 × 0.579) × $33.4009 = $664.57
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.71 | 1 |
| Practice expense | 5 | 1.137 |
| Malpractice | 0.86 | 0.579 |
(6.71 × 1 + 5 × 1.137 + 0.86 × 0.579) × $33.4009 = $430.64
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
30580 billing questions
When should 30580 be reported instead of a choanal atresia repair code?
Use 30580 for closure of a communication between the mouth and maxillary sinus. Codes 30540 and 30545 address choanal atresia, an abnormal blockage at the back of the nasal passage.
Can maxillary sinus surgery be reported with 30580?
A separately performed maxillary sinus procedure may be reported when the surgeon documents distinct treatment of sinus disease in addition to fistula closure. The record should describe the separate work performed.
Is modifier 50 appropriate for bilateral fistula repair?
No. The CMS bilateral adjustment does not apply to 30580, and modifier 50 is inappropriate for this code.
What postoperative care is included in the payment for 30580?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 30580. Co-surgeon and team-surgery reporting 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,4523055F,,Lvef less than/equal to 35%,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,45330560,,Lysis intranasal synechia,A,,1.28,7.97,,2.71,,0.19,9.44,4.18,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4543056F,,Lvef greater than 35%,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,45530580,,Repair upper jaw fistula,A,,6.71,11.16,,5.00,,0.86,18.73,12.57,0,090,0.10,0.76,0.14,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,45630600,,Repair mouth/nose fistula,A,,6.01,11.28,,4.67,,0.86,18.15,11.54,0,090,0.10,0.76,0.14,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4573060F,,Pos microalbuminuria rev,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4583061F,,Neg microalbuminuria rev,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014