CPT 30468 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 50 - Bilateral Procedure |
| Complexity Level | High |
National average reimbursement for CPT 30468 by major payers:
$2,888.19
$4,095.20
$3,656.97
$4,221.27
| 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 30468 | ||||||
United | 30468 | $3100.00 | 1639149255 - COLD SPRINGS MEDICAL SURGICAL GROUP LLC, DE LA VINA SURGICENTER | 770521530 - (CA) COLD SPRINGS MEDICAL SURGICAL GROUP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $2420.00 | 1346249604 - ST. MARY'S SURGICAL CENTER LLC, ST. MARY'S SURGICAL CENTER | 201685516 - (MO) ST MARYS SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $5463.47 | 1578527263 - EDWARD MOORE | 350593390 - DEACONESS HOSPITAL INC | IN | Interventional Cardiology Physician (207RI0011X) |
United | 30468 | $1400.00 | 1972853810 - UNIVERSITY OF HOUSTON SYSTEM, UH COLLEGE OF OPTOMETRY SURGERY CENTER | 746001399 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $2510.25 | 1063434470 - CATHY ROGERS | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 30468 | $3708.00 | 1669660817 - SPH IRVINE, L.L.C. | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $5020.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $3085.00 | 1093389421 - PEACHTREE ORTHOPAEDIC SURGERY CENTER-NORTH, LLC | 862640910 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTERNORTH LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $2275.00 | 1710163670 - PHYSICIAN SURGERY CENTER AT ANMED HEALTH LLC | 570359174 - ANMED HEALTH | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $5463.47 | 1548445927 - GEORGE GANDEV | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 30468 | $5580.00 | 1881662856 - SILICON VALLEY SURGERY CENTER, LP | 770495522 - (CA) SILICON VALLEY SURGERY CENTER, L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $9501.00 | 1629249172 - NORTH STATE SURGERY CENTERS LP, COURT STREET SURGERY CENTER | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $3371.00 | 1548213077 - PACIFIC CATARACT AND LASER INSTITUTE OF ALASKA INC PC | 911832600 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $4769.00 | 1689651481 - TETON OUTPATIENT SERVICES LLC | 841412817 - (WY) TETON OUTPATIENT SERVICES LLC | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30468 | $10317.00 | 1194997965 - INDIANAPOLIS ENDOSCOPY CENTER LLP | 352010874 - (IN) INDIANAPOLIS ENDOSCOPY CENTER LLP | IN | 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 30468 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 30468 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 30468 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 |
|---|---|---|
| 30468-CPT | High | Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant -Deny Inv/N10>=1/1/2021 |
| 30469-CPT | High | Repair Of Nasal Valve Collapse With Low Energy, Temperature-Controlled Subcutaneous/Submucosal Remodeling - Deny Inv/N10>=12/31/2024 |
| 30520-CPT | Moderate | Septoplasty W/Wo Cartilage Implant |
| 30560-CPT | Moderate | Lysis Intranasal Synechia |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 30468. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 30468 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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