No office rate
Both codes address choanal atresia, but 30540 is for an intranasal repair and 30545 is for a transpalatal repair. Follow the documented operative route.
On this page
CMS RVU26D · Effective 2026-10-01
30540 Choanal atresia repair Medicare reimbursement rates in Indiana
Reports surgical correction of congenital choanal blockage through an intranasal approach, commonly restoring posterior nasal airflow in an affected infant. Compare 30540 office and facility rates across CMS payment localities in Indiana.
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 30540 in Indiana?
Indiana 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
No supported rate
Facility setting
$625.77
1 of 1 localities have a supported rate.
Payment area: Indiana
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.
Nasal surgery
About 30540: Intranasal repair of choanal atresia
Reports surgical correction of congenital choanal blockage through an intranasal approach, commonly restoring posterior nasal airflow in an affected infant.
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.
CMS billing rules for 30540
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.72 · 38%
- Practice expense (office) RVU11.29 · 56%
- Malpractice RVU1.13 · 6%
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.
30540 compared with similar codes
Office rates for Indiana, from the same CMS release.
$292.61
30560 is for releasing intranasal adhesions. It is not the code for repairing congenital blockage of the posterior nasal passage.
No office rate
30520 addresses repair of the nasal septum. It does not represent correction of choanal atresia.
Compare 30540 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
Indiana →
Office / nonfacility
Unavailable
Facility
$625.77
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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 30540 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
3,450
- Code
- 30540
- Physician work
- 7.72
- Practice expense
- 11.29
- Malpractice
- 1.13
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.72 | × 1.000 | 7.7200 |
| Practice expense | 11.29 | × 0.927 | 10.4658 |
| Malpractice | 1.13 | × 0.486 | 0.5492 |
| Total RVUs | 18.7350 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$625.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.72 | 1 |
| Practice expense | 11.29 | 0.927 |
| Malpractice | 1.13 | 0.486 |
(7.72 × 1 + 11.29 × 0.927 + 1.13 × 0.486) × $33.4009 = $625.77
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.
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 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.
3,4473051F,,Hg a1c>equal 7.0%<8.0%,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
3,44830520,,Repair of nasal septum,A,,6.83,10.52,NA,10.52,,1.01,18.36,18.36,0,090,0.10,0.76,0.14,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4493052F,,Hg a1c>equal 8.0%<equal 9.0%,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
3,45030540,,Rpr choanal atresia ntranasl,A,,7.72,11.29,NA,11.29,,1.13,20.14,20.14,0,090,0.10,0.76,0.14,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,45130545,,Rpr choanal atresia trsnpltn,A,,11.33,14.03,NA,14.03,,1.65,27.01,27.01,0,090,0.10,0.76,0.14,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915