CPT 30420 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Respiratory System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • SG - Scene to Hospital ESRD facility • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 30420 |
National average reimbursement for CPT 30420 by major payers:
$1,796.70
$1,812.45
$2,038.85
$2,372.63
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 30420 | ||||||
United | 30420 | $3027.00 | 1568906212 - HOUSTON UROLOGIC SURGICENTER, LLC | 814537533 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $2600.00 | 1649463605 - PRINCETON ORTHOPAEDIC ASSOCIATES II PA | 223471829 - (NJ) PRINCETON ORTHOPAEDIC ASSOCIATES II, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $3200.00 | 1821036534 - PARKWAY SURGERY CENTER, LLC | 204127100 - (MD) PARKWAY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $3500.00 | 1558339424 - PREMIER SURGERY CENTER | 352206509 - (CA) PREMIPREMIER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $4312.00 | 1750568838 - VIVERE HEALTH DALLAS, LLC, VIVERE-DALLAS SURGERY CENTER | 364701304 - (TX) VIVERE HEALTH DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $2858.00 | 1144291923 - INTERVENTIONAL THERAPEUTICS INSTITUTE, LLC, CLEARWAY SURGERY CENTER | 830432335 - (FL) INTERVENTIONAL THERAPEUTICS INSTITUTE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $5433.00 | 1720325160 - SURGCENTER OF DEER VALLEY, LLC | 461512703 - (AZ) SURGCENTER OF DEER VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $5779.00 | 1528049855 - CENTER FOR AESTHETIC AND RECONSTRUCTIVE EYELID AND ORBITAL SURGERY, CAREOS | 844484446 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $2555.00 | 1134687981 - ARMENIA AMBULATORY SURGICAL CENTER, LLC | 833888664 - (FL) ARMENIA AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $3690.00 | 1790876431 - MAIN LINE SPINE SURGERY CENTER, LLC | 202547795 - (PA) MAIN LINE SPINE SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $1500.00 | 1376716316 - CPM SURGERY CENTER LLC | 261382311 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $1110.66 | 1487630091 - MICHAEL SMITH | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 30420 | $4358.00 | 1750491205 - ENT SURGERY CENTER OF ATLANTA,LLC | 200075229 - (GA) ENT SURGERY CENTER OF ATLANTALLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $3285.00 | 1275597056 - SURGERY CENTER OF ROME, LP | 200390305 - (GA) SURGERY CENTER OF ROME LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30420 | $1340.00 | 1508845942 - ENDOSCOPY CENTER OF KNOXVILLE LP, THE ENDOSCOPY CENTER WEST | 621512837 - (TN) ENDOSCOPY CENTER OF KNOXVILLE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 30420 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 30420 code is part of the Surgery services used for Surgical Procedures on the Respiratory System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 30420 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 30400-CPT | High | Rhinoplasty Primary Partial |
| 30410-CPT | High | Rhinoplasty, Primary; Complete, External Parts Including Bony Pyramid, Lateral & Alar Cartilages, &/Or Elevation Of Nasal Tip- Deny Cos/N09 |
| 30420-CPT | High | Rhinoplasty Primary Maj Septal Rep |
| 30450-CPT | High | Rhinoplasty,2ndary;Major Revision |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 30420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 30420 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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