CPT code 31231: Nasal endoscopy, diagnostic, without sinusoscopy2026 Medicare rate & RVUs

Medicare pays $193.39 for 31231 nationally in the office and $54.78 in a hospital or facility. Local office rates run $169.32–$262.16.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 31231 covers

An otolaryngologist, and sometimes an allergist or advanced practice provider, uses a rigid or flexible scope to inspect the nasal cavity in an office or outpatient facility. Topical decongestant or anesthetic may be used. The examination can show the septum, turbinates, middle meatus, sphenoethmoid recess, and nasopharynx when visualized. Common indications include chronic rhinosinusitis, nasal obstruction, recurrent epistaxis, suspected polyps or masses, and surveillance after sinus surgery when no debridement is performed.

Report one unit whether one or both sides are examined; the code is already priced as bilateral, so modifier 50 adds no payment. Document the indication, sides examined, structures viewed, and findings. Its 0-day global period includes same-day pre- and post-procedure care. A separately identifiable E/M service beyond that care may be reported with modifier 25 on the E/M code. For multiple procedures in the same session, the highest-valued is paid in full and other procedures subject to the standard reduction are paid at 50%. Medicare does not pay an assistant at surgery or permit co-surgeons or team surgery for this code.

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.

Where 31231 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

31231 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 31231 rate is calculated

Each of 31231’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 31231

The CMS indicators that decide how 31231 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

31231 compared with similar codes

How to choose

31233Sinus endoscopyMaxillary sinus

31231 inspects the nasal cavity and sinus openings without entering a sinus. 31233 includes direct examination inside the maxillary sinus.

31237Nasal endoscopyBiopsy, polypectomy, or debridement

Use 31237 when the nasal or sinus endoscopy includes biopsy, polyp removal, or debridement. Do not separately report 31231 for diagnostic inspection of the same site during that surgical endoscopy.

92511NasopharyngoscopyEndoscopic nasopharynx exam

92511 focuses on the nasopharynx. 31231 evaluates nasal cavity structures such as the meatuses, turbinates, and sphenoethmoid recess, even if the nasopharynx is also visualized.

31575LaryngoscopyFlexible, diagnostic

31575 examines the larynx with a flexible scope. Passing that scope through the nose does not alone support 31231; a separate medically necessary nasal cavity examination must be documented.

Codes related to 31231

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates