No office rate
This code is for a complicated septal defect repair. Code 30620 describes intranasal reconstruction; select according to the actual reconstructive work performed.
On this page
CMS RVU26D · Effective 2026-10-01
30630 Septal repair Medicare reimbursement rates in Pennsylvania
Repair of a complicated nasal septal defect, reported when operative treatment goes beyond a straightforward closure and addresses the defect’s complexity. Compare 30630 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 30630 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
$578.49–$632.79
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.
Otolaryngology surgery
About 30630: Complicated nasal septal defect repair
Repair of a complicated nasal septal defect, reported when operative treatment goes beyond a straightforward closure and addresses the defect’s complexity.
This code describes operative repair of a complicated defect in the nasal septum, commonly a perforation. An otolaryngologist or facial plastic surgeon performs the repair, typically in an operating room. The work may involve more extensive tissue mobilization or reconstruction than a straightforward closure; the operative report should make the defect and the complexity of the repair clear.
Select the code based on the documented operative work and the nature of the defect, not symptoms alone. The report should identify the septal defect and explain the steps that make the repair complicated. Medicare 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 other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 30630
- 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 RVU7.11 · 39%
- Practice expense (office) RVU10.02 · 55%
- Malpractice RVU1.07 · 6%
278
Medicare services in 2024 · #4052 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.
30630 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Septoplasty addresses a deviated septum. This code addresses repair of a complicated septal defect; report both only when the operative work supports distinct services.
$573.75–$630.83
Code 30600 is for repair of a mouth-to-nose fistula. This code is for a defect in the nasal septum.
Compare 30630 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
$632.79
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$578.49
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30630 billing questions
How does this differ from a straightforward septal defect repair?
Use this code when the operative report supports a complicated repair. A simpler repair belongs to the code level that describes that work; the diagnosis or defect size alone does not establish complexity.
Is modifier 50 appropriate for a defect involving both sides of the septum?
No. CMS specifies that a bilateral adjustment does not apply and modifier 50 is inappropriate for this code.
What documentation supports reporting the complicated repair?
Document the septal defect and the operative steps that made its repair complicated. A diagnosis or symptom list without a description of the repair is not enough to show the operative complexity.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
3,4583061F,,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
3,45930620,,Intranasal reconstruction,A,,6.01,11.60,NA,11.60,,0.88,18.49,18.49,0,090,0.10,0.76,0.14,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4603062F,,Pos macroalbuminuria 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
3,46130630,,Repair nasal septum defect,A,,7.11,10.02,NA,10.02,,1.07,18.20,18.20,0,090,0.10,0.76,0.14,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4623066F,,Nephropathy doc tx,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
3,4633072F,,Low risk for retinopathy,M,,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
3,4643073F,,Pre-surg eye measures docd,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