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See a sample rate comparisonCPT 30540 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery For Nose Opening, Surgery To Create Openings From The Nose Through The Roof Of The Mouth When These Are Not Present. The Procedure May Involve Removing Bony Structure. Tubes Are Placed While Healing To Ensure The Openings Do Not Close Over.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 30540 |
| Medicaid Fee Schedule | View Medicaid rates for 30540 |
National average reimbursement for CPT 30540 by major payers:
$931.14
$909.66
$1,003.68
$1,174.82
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CPT 30540
5 of 25 sample ratesHigher to lower in this preview
Advanced Surgery Center Of Orlando LLC
$8,520.00Published rateLakeway Ambulatory Surgery Center, LLC, Lakeway Surgery Center
Lakeway Ambulatory Surgery Center LLC
$3,200.00Published rateMission Valley Hegihts Surgery Center, Mission Valley Outpatient Surgery Center
Poway Ca Multi-Specialty Asc LLC
$2,400.00Published rateNew Lexington Clinic Psc, Dermatology Associates Of Kentucky Psc
Dermatology Associates Of Kentucky, P.S.C.
$1,316.75Published ratePremier Endoscopy Center,LLC
$383.00Published rate
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See a sample payer proposalCPT 30540 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 30540 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 30540 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 |
|---|---|---|
| 30410-CPT | High | Plastic Surgery On The Nose, Surgery To Reshape The Nose. A Simple Procedure May Lift The Tip Or Remove Excess Fatty Tissue. A More Complex Procedure Can Repair A Damaged Septum And Reshape Internal Nose Bones By Filing Or Breaking Them. |
| 30540-CPT | Moderate | Surgery For Nose Opening, Surgery To Create Openings From The Nose Through The Roof Of The Mouth When These Are Not Present. The Procedure May Involve Removing Bony Structure. Tubes Are Placed While Healing To Ensure The Openings Do Not Close Over. |
| 30545-CPT | High | Surgery For Nose Opening, Surgery To Create Openings From The Nose Through The Roof Of The Mouth When These Are Not Present. The Procedure May Involve Removing Bony Structure. Tubes Are Placed While Healing To Ensure The Openings Do Not Close Over. |
| 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 30540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 30540 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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