CPT code 31233: Sinus endoscopy, maxillary sinus2026 Medicare rate & RVUs in South Dakota
Reports diagnostic endoscopic inspection of the maxillary sinus through the nasal passage when the clinician evaluates disease within that sinus.
In South Dakota, Medicare pays $265.90 for 31233 in the office and $110.58 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 31233 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 31233 covers
An otolaryngologist or rhinologist passes an endoscope through the nasal cavity and into the maxillary sinus through its natural opening to inspect the sinus. The examination may help evaluate suspected maxillary sinus disease, such as persistent symptoms or an abnormal finding that requires direct visualization. This is distinct from an examination confined to the nasal cavity and from operative enlargement of the sinus opening or removal of tissue.
Report the service when the maxillary sinus is entered and diagnostically examined; document the approach, side or sides examined, and relevant findings. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. For bilateral reporting, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
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 South Dakota compares for 31233
Across 109 of 109 payment localities, the office rate for 31233 runs from $240.71 in Arkansas to $360.32 in San Benito County, CA. South Dakota pays $265.90. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$265.90
- Los Angeles, CA · California$307.13+$41.23
- Washington, DC area · District of Columbia$311.59+$45.69
- Miami, FL · Florida$295.72+$29.82
- Chicago, IL · Illinois$286.98+$21.08
- Manhattan, NY · New York$313.98+$48.08
- Alaska · Alaska$316.06+$50.16
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $244.28 | $108.38 |
| ArkansasArkansas | $240.71 | $107.29 |
| ArizonaArizona | $265.18 | $114.68 |
| Bakersfield, CACalifornia | $288.36 | $118.13 |
| Chico, CACalifornia | $287.48 | $117.26 |
| El Centro, CACalifornia | $287.53 | $117.31 |
| Fresno, CACalifornia | $287.48 | $117.26 |
| Hanford, CACalifornia | $287.48 | $117.26 |
| Madera, CACalifornia | $287.48 | $117.26 |
| Merced, CACalifornia | $287.48 | $117.26 |
| Modesto, CACalifornia | $287.48 | $117.26 |
| Napa, CACalifornia | $332.96 | $128.26 |
| Oxnard, CACalifornia | $305.60 | $122.02 |
| Redding, CACalifornia | $287.48 | $117.26 |
| Rest of CaliforniaCalifornia | $287.48 | $117.26 |
| Riverside, CACalifornia | $290.73 | $120.51 |
| Sacramento, CACalifornia | $301.66 | $121.03 |
| Salinas, CACalifornia | $300.54 | $120.53 |
| San Diego, CACalifornia | $307.61 | $121.85 |
| Marin County, CACalifornia | $352.36 | $133.36 |
| San Francisco, CACalifornia | $352.02 | $133.02 |
| San Benito County, CACalifornia | $360.32 | $136.36 |
| Santa Clara County, CACalifornia | $358.93 | $134.97 |
| San Luis Obispo, CACalifornia | $295.71 | $118.81 |
| Santa Cruz, CACalifornia | $310.54 | $121.84 |
| Santa Maria, CACalifornia | $301.66 | $120.57 |
| Santa Rosa, CACalifornia | $313.67 | $122.95 |
| Stockton, CACalifornia | $287.48 | $117.26 |
| Vallejo, CACalifornia | $332.47 | $127.77 |
| Visalia, CACalifornia | $287.48 | $117.26 |
| Yuba City, CACalifornia | $287.48 | $117.26 |
| ColoradoColorado | $283.46 | $118.21 |
| ConnecticutConnecticut | $290.82 | $123.54 |
| DelawareDelaware | $269.60 | $116.15 |
| Fort Lauderdale, FLFlorida | $283.14 | $125.80 |
| Rest of FloridaFlorida | $269.17 | $120.69 |
| Atlanta, GAGeorgia | $277.84 | $120.04 |
| Rest of GeorgiaGeorgia | $253.81 | $115.27 |
| Hawaii, Guam, HIHawaii | $294.55 | $117.96 |
| IowaIowa | $250.24 | $108.13 |
| IdahoIdaho | $251.96 | $109.07 |
| East St. Louis, ILIllinois | $267.40 | $124.51 |
| Rest of IllinoisIllinois | $261.54 | $119.74 |
| Suburban Chicago, ILIllinois | $285.95 | $126.44 |
| IndianaIndiana | $253.43 | $109.45 |
| KansasKansas | $249.21 | $108.80 |
| KentuckyKentucky | $250.46 | $112.38 |
| New Orleans, LALouisiana | $262.62 | $116.47 |
| Rest of LouisianaLouisiana | $250.12 | $112.67 |
| Metropolitan Boston, MAMassachusetts | $311.50 | $126.05 |
| Rest of MassachusettsMassachusetts | $281.80 | $118.25 |
| Baltimore area, MDMaryland | $290.04 | $123.38 |
| Rest of MarylandMaryland | $274.74 | $117.56 |
| Rest of MaineMaine | $253.45 | $110.56 |
| Southern Maine, MEMaine | $267.13 | $113.22 |
| Detroit, MIMichigan | $272.73 | $122.85 |
| Rest of MichiganMichigan | $257.19 | $115.39 |
| MinnesotaMinnesota | $271.05 | $111.23 |
| Metropolitan Kansas City, MOMissouri | $260.65 | $114.81 |
| Metropolitan St. Louis, MOMissouri | $263.38 | $115.53 |
| Rest of MissouriMissouri | $245.88 | $112.00 |
| MississippiMississippi | $243.33 | $109.61 |
| MontanaMontana | $272.53 | $117.22 |
| North CarolinaNorth Carolina | $256.11 | $111.20 |
| North DakotaNorth Dakota | $266.60 | $111.29 |
| NebraskaNebraska | $251.58 | $108.23 |
| New HampshireNew Hampshire | $279.15 | $117.46 |
| Northern New JerseyNew Jersey | $308.34 | $128.17 |
| Rest of New JerseyNew Jersey | $293.98 | $124.37 |
| New MexicoNew Mexico | $258.68 | $116.26 |
| NevadaNevada | $271.07 | $115.60 |
| NYC suburbs and Long Island, NYNew York | $321.86 | $137.20 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $296.04 | $125.97 |
| Queens, NYNew York | $316.37 | $132.78 |
| Rest of New YorkNew York | $260.01 | $112.46 |
| OhioOhio | $255.98 | $114.18 |
| OklahomaOklahoma | $249.84 | $111.14 |
| Portland, OROregon | $292.37 | $119.81 |
| Rest of OregonOregon | $268.81 | $114.12 |
| Metropolitan Philadelphia, PAPennsylvania | $283.61 | $121.93 |
| Rest of PennsylvaniaPennsylvania | $256.31 | $113.73 |
| Puerto RicoPuerto Rico | $274.51 | $117.48 |
| Rhode IslandRhode Island | $279.14 | $118.70 |
| South CarolinaSouth Carolina | $256.50 | $112.99 |
| TennesseeTennessee | $250.50 | $109.32 |
| Austin, TXTexas | $282.65 | $118.33 |
| Beaumont, TXTexas | $254.62 | $113.28 |
| Brazoria, TXTexas | $269.19 | $115.28 |
| Dallas, TXTexas | $271.00 | $116.31 |
| Fort Worth, TXTexas | $269.22 | $116.08 |
| Galveston, TXTexas | $270.06 | $115.83 |
| Houston, TXTexas | $275.55 | $121.32 |
| Rest of TexasTexas | $261.82 | $114.43 |
| UtahUtah | $260.05 | $114.05 |
| VirginiaVirginia | $266.35 | $113.68 |
| Virgin Islands, VIUnited States Virgin Islands | $274.51 | $117.48 |
| VermontVermont | $265.69 | $111.93 |
| Rest of WashingtonWashington | $281.22 | $117.68 |
| King County, WAWashington | $317.72 | $127.15 |
| WisconsinWisconsin | $257.58 | $108.79 |
| West VirginiaWest Virginia | $251.80 | $116.83 |
| WyomingWyoming | $269.95 | $114.63 |
31233 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$240.71
$323.90
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $316.06 | 1 |
| AL | $244.28 | 1 |
| AR | $240.71 | 1 |
| AZ | $265.18 | 1 |
| CA | $287.48–$360.32 | 29 |
| CO | $283.46 | 1 |
| CT | $290.82 | 1 |
| DC | $311.59 | 1 |
| DE | $269.60 | 1 |
| FL | $269.17–$295.72 | 3 |
| GA | $253.81–$277.84 | 2 |
| GU | $294.55 | 1 |
| HI | $294.55 | 1 |
| IA | $250.24 | 1 |
| ID | $251.96 | 1 |
| IL | $261.54–$286.98 | 4 |
| IN | $253.43 | 1 |
| KS | $249.21 | 1 |
| KY | $250.46 | 1 |
| LA | $250.12–$262.62 | 2 |
| MA | $281.80–$311.50 | 2 |
| MD | $274.74–$311.59 | 3 |
| ME | $253.45–$267.13 | 2 |
| MI | $257.19–$272.73 | 2 |
| MN | $271.05 | 1 |
| MO | $245.88–$263.38 | 3 |
| MS | $243.33 | 1 |
| MT | $272.53 | 1 |
| NC | $256.11 | 1 |
| ND | $266.60 | 1 |
| NE | $251.58 | 1 |
| NH | $279.15 | 1 |
| NJ | $293.98–$308.34 | 2 |
| NM | $258.68 | 1 |
| NV | $271.07 | 1 |
| NY | $260.01–$321.86 | 5 |
| OH | $255.98 | 1 |
| OK | $249.84 | 1 |
| OR | $268.81–$292.37 | 2 |
| PA | $256.31–$283.61 | 2 |
| PR | $274.51 | 1 |
| RI | $279.14 | 1 |
| SC | $256.50 | 1 |
| SD | $265.90 | 1 |
| TN | $250.50 | 1 |
| TX | $254.62–$282.65 | 8 |
| UT | $260.05 | 1 |
| VA | $266.35–$311.59 | 2 |
| VI | $274.51 | 1 |
| VT | $265.69 | 1 |
| WA | $281.22–$317.72 | 2 |
| WI | $257.58 | 1 |
| WV | $251.80 | 1 |
| WY | $269.95 | 1 |
How the 31233 rate is calculated
Each of 31233’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 · 31233
RVUs × geographic indexes × conversion factor
Work2.13
2.13 RVUs× 1.000 GPCI
Practice expense5.73
5.73 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
8.1600
Conversion factor
$33.4009
Medicare rate
$272.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,525
- Code
- 31233
- Physician work
- 2.13
- Practice expense
- 5.73
- Malpractice
- 0.30
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.13 | × 1.000 | 2.1300 |
| Practice expense | 5.73 | × 1.000 | 5.7300 |
| Malpractice | 0.30 | × 0.336 | 0.1008 |
| Total RVUs | 7.9608 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$265.90
Office: (2.13 × 1 + 5.73 × 1 + 0.3 × 0.336) × $33.4009 = $265.90
Facility: (2.13 × 1 + 1.08 × 1 + 0.3 × 0.336) × $33.4009 = $110.58
Payment rules and modifiers for 31233
The CMS indicators that decide how 31233 is paid alongside other services.
CMS payment indicators · 31233
Sinus endoscopy, maxillary sinus
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
31233 without 50 · national office
$272.55
Sinus endoscopy, maxillary sinus
31233-50 · Bilateral: 150%
$408.83
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 31233 has changed in South Dakota
31233 · Office / nonfacility
$265.90
Effective 2026-10-01
The base rate is $9.89 higher than on 2025-10-01, moving from $256.01 to $265.90 (3.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$256.01changed to$265.90
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.18 changed to 2.13
- Practice expense RVU 5.62 changed to 5.73
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$268.04changed to$256.01
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.75 changed to 5.62
- Malpractice RVU 0.32 changed to 0.30
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$263.66changed to$268.04
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$274.12changed to$263.66
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.80 changed to 5.75
- Malpractice RVU 0.30 changed to 0.32
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$278.15changed to$274.12
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.75 changed to 5.80
- Malpractice RVU 0.31 changed to 0.30
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$271.96changed to$278.15
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.51 changed to 5.75
- Malpractice RVU 0.30 changed to 0.31
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$262.02changed to$271.96
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.97 changed to 5.51
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$260.22changed to$262.02
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 4.92 changed to 4.97
- Malpractice RVU 0.31 changed to 0.30
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$256.92changed to$260.22
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.84 changed to 4.92
- Malpractice RVU 0.30 changed to 0.31
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$259.56changed to$256.92
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.93 changed to 4.84
- Malpractice RVU 0.31 changed to 0.30
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$262.59changed to$259.56
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 5.03 changed to 4.93
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$262.24changed to$262.59
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 4.99 changed to 5.03
- Malpractice RVU 0.32 changed to 0.31
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$260.94changed to$262.24
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$264.25changed to$260.94
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 5.08 changed to 4.99
- Malpractice RVU 0.28 changed to 0.32
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$270.32changed to$264.25
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 5.64 changed to 5.08
- Malpractice RVU 0.29 changed to 0.28
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $270.32
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $265.90 | $110.58 | RVU26D |
| 2026-07-01 | $265.90 | $110.58 | RVU26C |
| 2026-04-01 | $265.90 | $110.58 | RVU26B |
| 2026-01-01 | $265.90 | $110.58 | RVU26A |
| 2025-10-01 | $256.01 | $125.33 | RVU25D |
| 2025-07-01 | $256.01 | $125.33 | RVU25C |
| 2025-04-01 | $256.01 | $125.33 | RVU25B |
| 2025-01-01 | $256.01 | $125.33 | RVU25A |
| 2024-10-01 | $268.04 | $128.56 | RVU24D |
| 2024-07-01 | $268.04 | $128.56 | RVU24C |
| 2024-04-01 | $268.04 | $128.56 | RVU24B |
| 2024-03-09 | $268.04 | $128.56 | RVU24AR |
| 2024-01-01 | $263.66 | $126.47 | RVU24A |
| 2023-10-01 | $274.12 | $129.76 | RVU23D |
| 2023-07-01 | $274.12 | $129.76 | RVU23C |
| 2023-04-01 | $274.12 | $129.76 | RVU23B |
| 2023-01-01 | $274.12 | $129.76 | RVU23A |
| 2022-10-01 | $278.15 | $130.04 | RVU22D |
| 2022-07-01 | $278.15 | $130.04 | RVU22C |
| 2022-04-01 | $278.15 | $130.04 | RVU22B |
| 2022-01-01 | $278.15 | $130.04 | RVU22A |
| 2021-10-01 | $271.96 | $129.25 | RVU21D |
| 2021-07-01 | $271.96 | $129.25 | RVU21C |
| 2021-04-01 | $271.96 | $129.25 | RVU21B |
| 2021-01-01 | $271.96 | $129.25 | RVU21A |
| 2020-10-01 | $262.02 | $131.74 | RVU20D |
| 2020-07-01 | $262.02 | $131.74 | RVU20C |
| 2020-04-01 | $262.02 | $131.74 | RVU20B |
| 2020-01-01 | $262.02 | $131.74 | RVU20A |
| 2019-10-01 | $260.22 | $132.65 | RVU19D |
| 2019-07-01 | $260.22 | $132.65 | RVU19C |
| 2019-04-01 | $260.22 | $132.65 | RVU19B |
| 2019-01-01 | $260.22 | $132.65 | RVU19A |
| 2018-10-01 | $256.92 | $132.00 | RVU18D |
| 2018-07-01 | $256.92 | $132.00 | RVU18C |
| 2018-04-01 | $256.92 | $132.00 | RVU18B |
| 2018-01-01 | $256.92 | $132.00 | RVU18AR1 |
| 2017-10-01 | $259.56 | $133.59 | RVU17D |
| 2017-07-01 | $259.56 | $133.59 | RVU17C |
| 2017-04-01 | $259.56 | $133.59 | RVU17B |
| 2017-01-01 | $259.56 | $133.59 | RVU17A |
| 2016-10-01 | $262.59 | $134.41 | RVU16D |
| 2016-07-01 | $262.59 | $134.41 | RVU16C |
| 2016-04-01 | $262.59 | $134.41 | RVU16B |
| 2016-01-01 | $262.59 | $134.41 | RVU16A |
| 2015-10-01 | $262.24 | $134.68 | RVU15D |
| 2015-07-01 | $262.24 | $134.68 | RVU15C |
| 2015-04-01 | $260.94 | $134.01 | RVU15B |
| 2015-01-01 | $260.94 | $134.01 | RVU15A |
| 2014-10-01 | $264.25 | $135.64 | RVU14D |
| 2014-07-01 | $264.25 | $135.64 | RVU14C |
| 2014-04-01 | $264.25 | $135.64 | RVU14B |
| 2014-01-01 | $264.25 | $135.64 | RVU14A |
| 2013-10-01 | $270.32 | $133.21 | RVU13D |
| 2013-07-01 | $270.32 | $133.21 | RVU13C |
| 2013-04-01 | $270.32 | $133.21 | RVU13B |
| 2013-01-01 | $270.32 | $133.21 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
31233 billing questions
How does this differ from 31231?
31231 describes diagnostic nasal endoscopy limited to the nasal cavity. Use 31233 when the scope is advanced into and used to inspect the maxillary sinus.
How does this differ from 31235?
31235 is the diagnostic endoscopic examination of the sphenoid sinus. Code 31233 is for diagnostic examination of the maxillary sinus.
Can 31233 be reported with another endoscopy code?
Related endoscopies may be performed together, but CMS endoscopy family pricing applies. Document the distinct anatomic sites and services performed.
How is bilateral work reported?
For bilateral performance, report modifier 50; CMS pays 31233 at 150%. Document examination of both maxillary sinuses.
Can 31233 be reported for a maxillary antrostomy?
No. A diagnostic examination through the natural sinus opening is different from operative creation or enlargement of an opening, such as the service represented by 31256.
What documentation supports 31233?
Record that the endoscope entered the maxillary sinus, the side examined, and the diagnostic findings. A note describing nasal-cavity inspection alone supports a different service.
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
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