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

Report diagnostic nasal endoscopy for endoscopic inspection of the nasal passages, meatuses, and sphenoethmoid recess without sinus entry or surgical treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality739.4K Medicare services in 2024

In Detroit, MI, Medicare pays $191.73 for 31231 in the office and $57.96 when it’s performed in a hospital or facility.

$191.73Office (non-facility)
$57.96Hospital or facility
−0.9%vs the national office rate ($193.39)

Check a contract rate as a % of Medicare · 31231 nationwide

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

We’ll open 31231 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Detroit, MI
  2. What 31231 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Detroit, MI compares for 31231

Across 109 of 109 payment localities, the office rate for 31231 runs from $169.32 in Arkansas to $262.16 in San Benito County, CA. Detroit, MI pays $191.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

31231 in Detroit, MI vs other payment areas
  1. Detroit, MI · this page$191.73
  2. Rest of Michigan · Michigan$180.83−$10.90
  3. Los Angeles, CA · California$220.93+$29.20
  4. Washington, DC area · District of Columbia$223.04+$31.31
  5. Miami, FL · Florida$207.81+$16.08
  6. Chicago, IL · Illinois$201.32+$9.59
  7. Manhattan, NY · New York$223.48+$31.75

Other areas in Michigan first, then benchmark localities. Bars start at $0.

Every other payment area

31231 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$218.76$71.14
AlabamaAlabama$172.03$50.75
ArkansasArkansas$169.32$50.25
ArizonaArizona$187.90$53.58
Bakersfield, CACalifornia$206.60$54.68
Chico, CACalifornia$206.14$54.22
El Centro, CACalifornia$206.17$54.25
Fresno, CACalifornia$206.14$54.22

31231 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$169.32

$234.15

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
31231 office rate range by state
State / territoryOffice rate rangeLocalities
AK$218.761
AL$172.031
AR$169.321
AZ$187.901
CA$206.14–$262.1629
CO$202.401
CT$206.961
DC$223.041
DE$191.201
FL$189.38–$207.813
GA$177.97–$197.012
GU$212.011
HI$212.011
IA$177.221
ID$178.391
IL$183.15–$201.884
IN$179.531
KS$176.121
KY$176.031
LA$175.65–$185.132
MA$200.95–$223.822
MD$195.14–$223.043
ME$179.19–$190.052
MI$180.83–$191.732
MN$194.051
MO$172.23–$186.093
MS$170.831
MT$193.381
NC$181.261
ND$190.221
NE$178.341
NH$198.971
NJ$209.35–$220.382
NM$181.821
NV$192.651
NY$184.19–$229.045
OH$180.181
OK$175.901
OR$191.19–$209.502
PA$180.61–$201.312
PR$194.991
RI$198.521
SC$181.011
SD$189.841
TN$177.061
TX$179.30–$201.698
UT$183.711
VA$189.23–$223.042
VI$194.991
VT$189.231
WA$200.65–$228.772
WI$183.301
WV$175.741
WY$192.001

See 31231 in every payment locality

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.

How the rate is built · 31231

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.07

1.07 RVUs× 1.000 GPCI

Practice expense4.56

4.56 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

5.7900

Conversion factor

$33.4009

Medicare rate

$193.39

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Detroit, MI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,524

Code
31231
Physician work
1.07
Practice expense
4.56
Malpractice
0.16

GPCI2026.csv

64

Locality
Detroit, MI
Physician work
1.000
Practice expense
0.965
Malpractice
1.686
Office calculation for 31231 in Detroit, MI
ComponentRVULocality factorAdjusted
Physician work1.07× 1.0001.0700
Practice expense4.56× 0.9654.4004
Malpractice0.16× 1.6860.2698
Total RVUs5.7402
Conversion factor× 33.4009

Office rate, Detroit, MI$191.73

Office: (1.07 × 1 + 4.56 × 0.965 + 0.16 × 1.686) × $33.4009 = $191.73

Facility: (1.07 × 1 + 0.41 × 0.965 + 0.16 × 1.686) × $33.4009 = $57.96

Open 31231 in the RVU calculator

Payment rules and modifiers for 31231

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

CMS payment indicators · 31231

Nasal endoscopy, diagnostic, without sinusoscopy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

31231 without 51 · national office

$193.39

Nasal endoscopy, diagnostic, without sinusoscopy

31231-51 · Second procedure: 50%

$96.70

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 31231

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

Codes related to 31231
CodeHow it relatesOffice range, Detroit, MI
Same family
31233Sinus endoscopy, maxillary sinusDiagnostic endoscopy that includes direct examination inside the maxillary sinus.$272.73
31235Sinus endoscopy, diagnostic sphenoid sinusoscopyDiagnostic endoscopy that includes direct examination inside the sphenoid sinus.$311.35
31237Nasal endoscopy, biopsy, polypectomy, or debridementSurgical nasal or sinus endoscopy with biopsy, polyp removal, or debridement.$269.09
31238Nasal endoscopy, hemorrhage controlSurgical nasal endoscopy that treats bleeding rather than only inspecting the nasal cavity.$263.60
Used instead
92511Nasopharyngoscopy, endoscopic nasopharynx examNasopharyngoscopy when the nasopharynx, rather than nasal cavity structures, is the examination's focus.$113.50
Often billed with
99213Office visit, established patient, low complexityEstablished-patient E/M when that level is supported and the service is separately identifiable; append modifier 25.$95.55

How 31231 has changed in Detroit, MI

31231 · Office / nonfacility

$191.73

Effective 2026-10-01

The base rate is $5.86 higher than on 2025-10-01, moving from $185.87 to $191.73 (3.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $185.87changed to$191.73

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.10 changed to 1.07
    • Practice expense RVU 4.43 changed to 4.56
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 0.986 changed to 0.965
    • Malpractice GPCI 1.718 changed to 1.686

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $189.31changed to$185.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.37 changed to 4.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $186.22changed to$189.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $195.82changed to$186.22

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.43 changed to 4.37
    • Malpractice RVU 0.17 changed to 0.16
    • Work GPCI 1.000 changed to 1.003
    • Practice expense GPCI 0.992 changed to 0.986
    • Malpractice GPCI 1.670 changed to 1.718

  5. January 1, 2023

    RVU23A

    $198.43changed to$195.82

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.42 changed to 4.43
    • Malpractice RVU 0.14 changed to 0.17
    • Practice expense GPCI 0.997 changed to 0.992
    • Malpractice GPCI 1.622 changed to 1.670

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $204.81changed to$198.43

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.54 changed to 4.42
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $199.78changed to$204.81

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.25 changed to 4.54
    • Malpractice RVU 0.13 changed to 0.15
    • Practice expense GPCI 0.993 changed to 0.997
    • Malpractice GPCI 1.657 changed to 1.622

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $207.29changed to$199.78

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.43 changed to 4.25
    • Malpractice RVU 0.16 changed to 0.13
    • Practice expense GPCI 0.989 changed to 0.993
    • Malpractice GPCI 1.691 changed to 1.657

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $216.68changed to$207.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.70 changed to 4.43

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $213.87changed to$216.68

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.67 changed to 4.70
    • Malpractice RVU 0.15 changed to 0.16
    • Practice expense GPCI 0.992 changed to 0.989
    • Malpractice GPCI 1.510 changed to 1.691

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $215.57changed to$213.87

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.75 changed to 4.67
    • Practice expense GPCI 0.994 changed to 0.992
    • Malpractice GPCI 1.328 changed to 1.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $215.39changed to$215.57

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.71 changed to 4.75
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $214.32changed to$215.39

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $216.23changed to$214.32

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.11 changed to 0.16
    • Work GPCI 1.010 changed to 1.000
    • Practice expense GPCI 1.009 changed to 0.994
    • Malpractice GPCI 1.571 changed to 1.328

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $226.99changed to$216.23

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.21 changed to 4.71
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.022 changed to 1.010
    • Practice expense GPCI 1.023 changed to 1.009
    • Malpractice GPCI 1.814 changed to 1.571

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $226.99

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$191.73$57.96RVU26D
2026-07-01$191.73$57.96RVU26C
2026-04-01$191.73$57.96RVU26B
2026-01-01$191.73$57.96RVU26A
2025-10-01$185.87$65.95RVU25D
2025-07-01$185.87$65.95RVU25C
2025-04-01$185.87$65.95RVU25B
2025-01-01$185.87$65.95RVU25A
2024-10-01$189.31$67.87RVU24D
2024-07-01$189.31$67.87RVU24C
2024-04-01$189.31$67.87RVU24B
2024-03-09$189.31$67.87RVU24AR
2024-01-01$186.22$66.76RVU24A
2023-10-01$195.82$69.08RVU23D
2023-07-01$195.82$69.08RVU23C
2023-04-01$195.82$69.08RVU23B
2023-01-01$195.82$69.08RVU23A
2022-10-01$198.43$67.66RVU22D
2022-07-01$198.43$67.66RVU22C
2022-04-01$198.43$67.66RVU22B
2022-01-01$198.43$67.66RVU22A
2021-10-01$204.81$68.09RVU21D
2021-07-01$204.81$68.09RVU21C
2021-04-01$204.81$68.09RVU21B
2021-01-01$204.81$68.09RVU21A
2020-10-01$199.78$68.62RVU20D
2020-07-01$199.78$68.62RVU20C
2020-04-01$199.78$68.62RVU20B
2020-01-01$199.78$68.62RVU20A
2019-10-01$207.29$70.78RVU19D
2019-07-01$207.29$70.78RVU19C
2019-04-01$207.29$70.78RVU19B
2019-01-01$207.29$70.78RVU19A
2018-10-01$216.68$70.35RVU18D
2018-07-01$216.68$70.35RVU18C
2018-04-01$216.68$70.35RVU18B
2018-01-01$216.68$70.35RVU18AR1
2017-10-01$213.87$69.32RVU17D
2017-07-01$213.87$69.32RVU17C
2017-04-01$213.87$69.32RVU17B
2017-01-01$213.87$69.32RVU17A
2016-10-01$215.57$68.58RVU16D
2016-07-01$215.57$68.58RVU16C
2016-04-01$215.57$68.58RVU16B
2016-01-01$215.57$68.58RVU16A
2015-10-01$215.39$69.31RVU15D
2015-07-01$215.39$69.31RVU15C
2015-04-01$214.32$68.96RVU15B
2015-01-01$214.32$68.96RVU15A
2014-10-01$216.23$69.12RVU14D
2014-07-01$216.23$69.12RVU14C
2014-04-01$216.23$69.12RVU14B
2014-01-01$216.23$69.12RVU14A
2013-10-01$226.99$69.67RVU13D
2013-07-01$226.99$69.67RVU13C
2013-04-01$226.99$69.67RVU13B
2013-01-01$226.99$69.67RVU13AR

Price 31231 for an earlier date of service

Where the Detroit, MI rate applies

Detroit, MI is a Medicare payment area, not a city. Our Census mapping connects it to 98 cities and communities in Michigan. Some span more than one payment area; confirm with the service ZIP.

  • Detroit
  • Allen Park
  • Ann Arbor
  • Armada
  • Auburn Hills
  • Barton Hills
  • Belleville
  • Berkley

Browse all communities in Michigan

31231 billing questions

Should modifier 50 or RT/LT be added when both sides of the nose are scoped?

No. Report one unit for a bilateral examination without modifier 50 or RT/LT; the code is already priced as bilateral.

Can this code be billed with a surgical sinus endoscopy on the same side?

Do not separately report the diagnostic inspection of the same site during a surgical nasal or sinus endoscopy. Report the applicable surgical code when biopsy, polyp removal, or ethmoidectomy is performed.

When should 31233 or 31235 be reported instead?

Use 31233 for diagnostic maxillary sinusoscopy and 31235 for diagnostic sphenoid sinusoscopy. Inspection of the nasal cavity and sinus openings without entering either sinus remains 31231.

Can an office visit be billed on the same day as the endoscopy?

Yes, if the E/M service is significant and separately identifiable from the routine assessment and same-day care included with the endoscopy. Append modifier 25 to the E/M code.

Does passing a flexible laryngoscope through the nose support a separate nasal endoscopy?

No. Transnasal passage to examine the larynx does not by itself establish a separate diagnostic nasal examination. Report 31231 only when a medically necessary nasal cavity examination is separately performed and documented.

What documentation supports the procedure?

Record the indication, sides examined, structures viewed, and endoscopic findings. Document the scope type and any anesthetic or decongestant used; a note stating only “nasal exam” does not establish the endoscopic examination.

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

Show the CMS file lines behind this rate
RVUs for 31231PPRRVU2026_Oct_nonQPP.csv, line 3,524 (RVU26D)
Geographic factors for Detroit, MIGPCI2026.csv, line 64 (RVU26D)

Open CMS sourceHow we calculate rates

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