No office rate
Both codes repair choanal atresia; 30545 is for the transpalatal approach, while 30540 is for the intranasal approach.
On this page
CMS RVU26D · Effective 2026-10-01
30545 Choanal repair Medicare reimbursement rates in Iowa
Surgical correction of congenital blockage at the back of the nasal passage through a transpalatal approach, rather than an intranasal repair. Compare 30545 office and facility rates across CMS payment localities in Iowa.
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 30545 in Iowa?
Iowa 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
$829.09
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
ENT surgery
About 30545: Transpalatal choanal atresia repair
Surgical correction of congenital blockage at the back of the nasal passage through a transpalatal approach, rather than an intranasal repair.
This operation corrects choanal atresia, a congenital blockage between the nasal cavity and throat, by reaching the obstructed posterior nasal airway through the palate. An otolaryngologist typically performs it in an operating room when the surgeon selects this approach to open the blocked passage. Choanal atresia can cause serious breathing difficulty in newborns, particularly when both sides are blocked; the diagnosis and operative findings establish the condition being treated.
Report 30545 for the transpalatal repair, not for an intranasal repair. The operative report should identify the atresia, the approach used, and the repair performed. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. If 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% multiple-procedure reduction. Bilateral adjustment is not appropriate for this code. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 30545
- 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 RVU11.33 · 42%
- Practice expense (office) RVU14.03 · 52%
- Malpractice RVU1.65 · 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.
30545 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Use 30520 for repair of the nasal septum. It does not describe opening congenital choanal obstruction through the palate.
$288.85
30560 treats intranasal synechia, or adhesions, rather than choanal atresia. Select based on the obstruction documented and treated.
Compare 30545 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
Iowa →
Office / nonfacility
Unavailable
Facility
$829.09
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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 30545 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,451
- Code
- 30545
- Physician work
- 11.33
- Practice expense
- 14.03
- Malpractice
- 1.65
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.33 | × 1.000 | 11.3300 |
| Practice expense | 14.03 | × 0.915 | 12.8375 |
| Malpractice | 1.65 | × 0.397 | 0.6551 |
| Total RVUs | 24.8225 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$829.09
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.33 | 1 |
| Practice expense | 14.03 | 0.915 |
| Malpractice | 1.65 | 0.397 |
(11.33 × 1 + 14.03 × 0.915 + 1.65 × 0.397) × $33.4009 = $829.09
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.
30545 billing questions
How do I choose between 30545 and 30540?
Choose 30545 when the surgeon repairs choanal atresia through a transpalatal approach. Code 30540 describes repair through an intranasal approach.
What documentation supports 30545?
Document the choanal atresia, the transpalatal approach, and the operative work performed to correct the blockage. The operative report should make the approach distinguishable from an intranasal repair.
Can I append modifier 50 for bilateral atresia?
No. CMS identifies bilateral adjustment as inappropriate for this code, even when atresia affects both sides.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Care unrelated to the repair is not described by that global-period rule.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery for this code.
What happens when another procedure is performed 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% when performed in the same session.
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.
3,44830520,,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
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
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136