CPT 30580 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 30580 |
| Medicaid Fee Schedule | View Medicaid rates for 30580 |
National average reimbursement for CPT 30580 by major payers:
$777.08
$812.10
$864.99
$794.24
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 30580 | $2665.00 | 1861930729 - FRESNO SPECIALTY SURGERY CENTER PC | 814226298 - (CA) FRESNO SPECIALTY SURGERY CENTER PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $3000.00 | 1114984523 - AUGUSTA UROLOGY SURGICENTER, LLC | 582360326 - (GA) AUGUSTA UROLOGY SURGICENTER, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $2679.00 | 1023297553 - PHYSICIANS SURGERY CENTER, LLC | 260425547 - (IL) PHYSICIANS SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $3077.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $1445.00 | 1801849427 - MAIN STREET ASC LLC, OPHTHALMIC ASSOCIATES SURGERY AND LASER CENTER | 383711415 - (PA) MAIN STREET ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $1415.00 | 1265770572 - PHILADELPHIA SURGERY CENTER, INC. | 454790325 - (PA) PHILADELPHIA SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $5433.00 | 1326527680 - INTRACOASTAL SURGERY CENTER, LLC | 824525706 - (FL) INTRACOASTAL SURGERY CENTER LL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $2438.00 | 1073546875 - STRAND GASTROINTESTINAL ENDOSCOPY CENTER | 571082826 - (SC) STRAND GASTROINTESTINAL ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $3100.00 | 1427545540 - ORBIS SURGERY CENTER LLC | 825184428 - (TX) ORBIS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $3275.00 | 1457448912 - GLADIOLUS SURGERY CENTER , LLC | 651025514 - (FL) GLADIOLUS SURGERY CENTER L L C | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $971.00 | 1063593952 - CONNECTICUT GI ENDOSCOPY CENTER LLC | 61573358 - (CT) CONNECTICUT GI ENDOSCOPY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $2489.00 | 1184106049 - SURGCENTER OF NORTHERN BALTIMORE, LLC | 823078615 - (MD) SURGCENTER OF NORTHERN BALTIMORE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $4123.00 | 1376634683 - MONTGOMERY SURGICAL CENTER, LTD | 752365748 - (AL) MONTGOMERY SURGICAL CENTER LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $2395.00 | 1073598066 - UROLOGY SURGERY CENTER LP | 621543096 - (TN) UROLOGY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30580 | $2927.00 | 1447613344 - PREMIER SURGICAL CENTER LLC | 811222482 - (MO) PREMIER SURGICAL CENTER LLC | MO | 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 30580 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 30580 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 30580 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 |
|---|---|---|
| 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. |
| 30580-CPT | Moderate | Rpair Fistula; Oromxillary (Cmbine W/ 31030 If Antrotomy Is Inclu, Repair Fistula; Oromaxillary (Combine With 31030 If Antrotomy Is Inclu |
| 30600-CPT | Moderate | Repair Fistula; Oronasal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 30580. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 30580 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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