$2,205.69–$2,492.27
Use 30468 when the nasal-valve repair uses an implant. Use 30465 for surgical reconstruction of stenosis, such as structural grafting.
On this page
CMS RVU26D · Effective 2026-10-01
30465 Nasal stenosis repair Medicare reimbursement rates in Pennsylvania
Reports surgical reconstruction of a narrowed nasal vestibule, such as structural grafting to relieve obstruction from stenosis or weakened nasal support. Compare 30465 office and facility rates across CMS payment localities in Pennsylvania.
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 30465 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$881.81–$960.54
2 of 2 localities have a supported rate.
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 30465: Surgical repair of nasal vestibular narrowing
Reports surgical reconstruction of a narrowed nasal vestibule, such as structural grafting to relieve obstruction from stenosis or weakened nasal support.
An otolaryngologist or facial plastic surgeon uses this service to surgically widen or support a narrowed nasal vestibule when structural stenosis contributes to nasal airflow obstruction. Repair may involve grafting or reconstruction of the lateral nasal wall or other supporting structures, often through an open or endonasal approach. The operative report should identify the site and nature of the narrowing, the functional problem, and the corrective reconstruction performed.
Report the code for the structural stenosis repair, rather than for nasal reshaping alone or a less invasive nasal-valve treatment. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Do not append modifier 50; CMS identifies bilateral adjustment as inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this service.
CMS billing rules for 30465
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.05 · 44%
- Practice expense (office) RVU13.79 · 50%
- Malpractice RVU1.79 · 6%
3.8K
Medicare services in 2024 · #2039 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.
30465 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$2,139.08–$2,417.93
Use 30469 for radiofrequency remodeling of nasal-valve collapse. Use 30465 for structural reconstruction of nasal vestibular narrowing.
30420
No office rateReconstruction of nose
30420 describes primary rhinoplasty with major septal repair. Choose 30465 when the service is specifically a structural repair of nasal vestibular stenosis.
Compare 30465 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$960.54
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$881.81
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30465 billing questions
How is this different from nasal-valve implant or radiofrequency treatment?
This code describes structural surgical reconstruction for stenosis, such as grafting or lateral-wall support. Codes 30468 and 30469 describe nasal-valve treatments using an implant or radiofrequency remodeling, respectively.
Can modifier 50 be used when both sides are repaired?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not report modifier 50.
What documentation supports reporting this repair?
Document the obstructed or narrowed nasal vestibule, the structural cause and location, and the reconstruction performed. The operative note should make clear that the work addressed stenosis rather than nasal appearance alone.
Is routine postoperative care separately reported during the global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.
When are multiple-procedure reductions relevant?
When this repair and other procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this service.
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.
3,43730450,,Revision of nose,R,,19.17,26.39,NA,26.39,,3.56,49.12,49.12,0,090,0.10,0.76,0.14,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,43830460,,Revision of nose,A,,10.06,11.05,NA,11.05,,1.87,22.98,22.98,0,090,0.10,0.76,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,43930462,,Revision of nose,A,,19.77,20.32,NA,20.32,,3.67,43.76,43.76,0,090,0.10,0.76,0.14,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,44030465,,Repair nasal stenosis,A,,12.05,13.79,NA,13.79,,1.79,27.63,27.63,0,090,0.10,0.76,0.14,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,44130468,,Rpr nsl vlv collapse w/implt,A,,2.73,68.55,,1.23,,0.40,71.68,4.36,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,44230469,,Rpr nsl vlv collapse w/rmdlg,A,,2.38,66.80,,1.14,,0.36,69.54,3.88,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4433046F,,Hemoglobin a1c level >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