$2,220.67
Choose 30468 for lateral wall support with an implant; 30469 describes treatment using radiofrequency remodeling.
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CMS RVU26D · Effective 2026-10-01
30468 Nasal valve repair Medicare reimbursement rates in Wisconsin
Reports implant-based support of collapsing nasal valve sidewalls causing obstruction, performed bilaterally by placing an implant beneath the nasal lining. Compare 30468 office and facility rates across CMS payment localities in Wisconsin.
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 30468 in Wisconsin?
Wisconsin 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
$2288.77
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$134.66
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Otolaryngology
About 30468: Nasal valve support with implant
Reports implant-based support of collapsing nasal valve sidewalls causing obstruction, performed bilaterally by placing an implant beneath the nasal lining.
This procedure supports weakened nasal valve sidewalls with an implant placed under the skin or lining of the lateral nasal wall. It is used for nasal obstruction associated with valve collapse, including inward movement of the sidewall during breathing. Otolaryngologists and facial plastic surgeons typically perform it in an office procedure room or an operating room. The technique differs from radiofrequency remodeling and from reconstruction using grafts or other structural methods.
Report the code for the bilateral implant procedure; CMS pricing already accounts for both sides, so modifier 50 does not increase payment. Documentation should identify nasal valve collapse, the obstruction being treated, and implant placement. The 0-day global period includes same-day preoperative and 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 50% reduction. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 30468
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.73 · 4%
- Practice expense (office) RVU68.55 · 96%
- Malpractice RVU0.40 · 1%
764
Medicare services in 2024 · #3196 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.
30468 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
30465 is for repair of nasal vestibular stenosis, generally using structural repair techniques. Do not select it solely because an implant is used to support a collapsing valve.
30420
No office rateReconstruction of nose
30420 describes broader nasal reconstruction with major septal repair. This code is specific to implant-based lateral wall support for valve collapse.
Compare 30468 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
Wisconsin →
Office / nonfacility
$2288.77
Facility
$134.66
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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 30468 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
3,441
- Code
- 30468
- Physician work
- 2.73
- Practice expense
- 68.55
- Malpractice
- 0.40
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.73 | × 1.000 | 2.7300 |
| Practice expense | 68.55 | × 0.958 | 65.6709 |
| Malpractice | 0.40 | × 0.308 | 0.1232 |
| Total RVUs | 68.5241 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$2288.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.73 | 1 |
| Practice expense | 68.55 | 0.958 |
| Malpractice | 0.4 | 0.308 |
(2.73 × 1 + 68.55 × 0.958 + 0.4 × 0.308) × $33.4009 = $2288.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.73 | 1 |
| Practice expense | 1.23 | 0.958 |
| Malpractice | 0.4 | 0.308 |
(2.73 × 1 + 1.23 × 0.958 + 0.4 × 0.308) × $33.4009 = $134.66
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.
30468 billing questions
Should this code be reported for one side only?
The CMS pricing treats the code as bilateral. Modifier 50 does not increase payment; document the sides treated and the implant placement.
How does this differ from radiofrequency nasal valve treatment?
This code is for support provided by a lateral wall implant. Code 30469 describes a radiofrequency remodeling approach.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. CMS does not permit co-surgeons or team surgery.
What happens when another procedure is performed in the same session?
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.
3,43830460,,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
3,4443048F,,Ldl-c <100 mg/dl,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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,