CPT code 31237: Nasal endoscopy, biopsy, polypectomy, or debridement2026 Medicare rate & RVUs

Medicare pays $266.54 for 31237 nationally in the office and $138.28 in a hospital or facility. Local office rates run $236.67–$344.99.

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

What 31237 covers

An otolaryngologist typically performs this procedure in an office, ambulatory surgery center, or hospital. Through a nasal endoscope, the physician obtains a biopsy, removes a polyp, or clears material such as crusts, clots, or devitalized tissue. Debridement may be performed during follow-up after endoscopic sinus surgery; the documented service must support actual endoscopic tissue treatment rather than inspection alone.

Select the code based on the work performed, and document the treated site and side, the tissue action, and any specimen sent for pathology. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral work, modifier 50 is paid at 150%. When related endoscopies are performed together, endoscopy-family pricing applies. An assistant at surgery is not paid under the statutory restriction; 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.

Where 31237 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

31237 rates by state

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

How the 31237 rate is calculated

Each of 31237’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 31237

The CMS indicators that decide how 31237 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

31237 compared with similar codes

How to choose

31231Nasal endoscopyDiagnostic, without sinusoscopy

This code includes biopsy, polypectomy, or debridement. Choose 31231 for diagnostic nasal endoscopy without those tissue-treatment services.

31238Nasal endoscopyHemorrhage control

31238 is for endoscopic surgical control of nasal bleeding. Use 31237 for biopsy, polyp removal, or debridement rather than hemostasis as the primary work.

31254EthmoidectomyPartial, anterior ethmoid

31254 describes endoscopic partial ethmoidectomy. It represents sinus surgery on the ethmoid, not the biopsy, polypectomy, or debridement service described by this code.

31267Sinus endoscopyMaxillary tissue removal

31267 describes endoscopic maxillary sinus surgery with tissue removal. Distinguish that sinus operation from a separately documented biopsy, polypectomy, or debridement service.

Codes related to 31237

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