CPT code 30600: Fistula repair2026 Medicare rate & RVUs in Minnesota
Repair an abnormal opening between the mouth and nasal cavity, commonly after cleft palate surgery, trauma, or tissue removal.
Medicare pays $596.93 for 30600 in the office in Minnesota (Minnesota). 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 30600 covers
This operation closes an abnormal passage connecting the oral and nasal cavities. It may be needed for a persistent opening after cleft palate repair or after trauma or removal of tissue. The surgeon identifies the communication and closes it, often using adjacent tissue. Otolaryngologists, plastic surgeons, and oral and maxillofacial surgeons may perform the repair in a hospital or surgical facility, or in an appropriately equipped office setting.
Report 30600 when the documented defect is an oronasal fistula and the service closes that communication. The operative note should identify the oral and nasal sides of the opening and describe the repair. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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.
30600 in Minnesota
| Payment locality | Office | Facility |
|---|---|---|
| Minnesota | $596.93 | $369.75 |
How the 30600 rate is calculated
Each of 30600’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 · 30600
RVUs × geographic indexes × conversion factor
Work6.01
6.01 RVUs× 1.000 GPCI
Practice expense11.28
11.28 RVUs× 1.000 GPCI
Malpractice0.86
0.86 RVUs× 1.000 GPCI
Adjusted RVUs
18.1500
Conversion factor
$33.4009
Medicare rate
$606.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 30600
30600 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 30600
Fistula repair
| 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) | 0 | Not paid without supporting documentation. |
| 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) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 30600
Fistula 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
30600 without 51 · national office
$606.23
Fistula repair
30600-51 · Second procedure: 50%
$303.12
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%).
30600 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 30580Fistula repair
- 30600 closes a communication between the oral and nasal cavities; 30580 is for a nasolabial fistula.
- 30630Septal repair
- 30630 addresses a nasal septal defect. Choose 30600 when the defect is an oronasal fistula.
- 30620Intranasal reconstruction
- 30620 describes intranasal reconstruction; 30600 specifically closes a passage between the mouth and nasal cavity.
30600 billing questions
How is an oronasal fistula different from a nasolabial fistula?
30600 is for a communication between the mouth and nasal cavity. Use 30580 when the documented defect is a nasolabial fistula.
What documentation supports reporting 30600?
Document the opening's location and its communication between the oral and nasal cavities, along with the closure performed.
Can modifier 50 be used for fistulas on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
What if another procedure is performed during the same session?
CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full, and other procedures are reduced. Assistant-at-surgery payment requires documentation of medical necessity; 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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