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

Report this surgical nasal or sinus endoscopy when the physician biopsies tissue, removes a polyp, or debrides postoperative material under endoscopic guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality85.6K Medicare services in 2024

In Delaware, Medicare pays $263.68 for 31237 in the office and $136.96 when it’s performed in a hospital or facility.

$263.68Office (non-facility)
$136.96Hospital or facility
−1.1%vs the national office rate ($266.54)

Check a contract rate as a % of Medicare · 31237 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 31237 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 31237 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 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.

How Delaware compares for 31237

Across 109 of 109 payment localities, the office rate for 31237 runs from $236.67 in Arkansas to $344.99 in San Benito County, CA. Delaware pays $263.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

31237 in Delaware vs other payment areas
  1. Delaware · this page$263.68
  2. Los Angeles, CA · California$296.85+$33.17
  3. Washington, DC area · District of Columbia$302.66+$38.98
  4. Miami, FL · Florida$292.38+$28.70
  5. Chicago, IL · Illinois$283.98+$20.30
  6. Manhattan, NY · New York$306.64+$42.96
  7. Alaska · Alaska$314.42+$50.74

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

Every other payment area

31237 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$240.01$127.78
ArkansasArkansas$236.67$126.49
ArizonaArizona$259.51$135.23
Bakersfield, CACalifornia$279.58$139.00
Chico, CACalifornia$278.50$137.93
El Centro, CACalifornia$278.57$137.99
Fresno, CACalifornia$278.50$137.93
Hanford, CACalifornia$278.50$137.93

31237 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.

$236.67

$314.42

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

View every state and territory as a table
31237 office rate range by state
State / territoryOffice rate rangeLocalities
AK$314.421
AL$240.011
AR$236.671
AZ$259.511
CA$278.50–$344.9929
CO$275.691
CT$283.871
DC$302.661
DE$263.681
FL$265.30–$292.383
GA$250.62–$271.992
GU$284.541
HI$284.541
IA$244.691
ID$246.481
IL$258.76–$283.984
IN$247.821
KS$244.151
KY$246.691
LA$246.55–$258.232
MA$274.36–$301.512
MD$268.41–$302.663
ME$248.32–$260.452
MI$253.40–$269.092
MN$262.751
MO$242.85–$258.443
MS$239.781
MT$266.511
NC$250.731
ND$259.201
NE$245.811
NH$271.941
NJ$286.71–$299.822
NM$254.971
NV$264.641
NY$254.40–$314.575
OH$251.911
OK$245.661
OR$262.19–$283.532
PA$251.97–$277.392
PR$268.221
RI$272.401
SC$251.821
SD$258.331
TN$245.411
TX$250.42–$275.128
UT$255.121
VA$260.03–$302.662
VI$268.221
VT$258.741
WA$273.66–$306.962
WI$250.871
WV$249.681
WY$263.331

See 31237 in every payment locality

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.

How the rate is built · 31237

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.54

2.54 RVUs× 1.000 GPCI

Practice expense5.07

5.07 RVUs× 1.000 GPCI

Malpractice0.37

0.37 RVUs× 1.000 GPCI

Adjusted RVUs

7.9800

Conversion factor

$33.4009

Medicare rate

$266.54

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,527

Code
31237
Physician work
2.54
Practice expense
5.07
Malpractice
0.37

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 31237 in Delaware
ComponentRVULocality factorAdjusted
Physician work2.54× 1.0052.5527
Practice expense5.07× 0.9885.0092
Malpractice0.37× 0.8990.3326
Total RVUs7.8945
Conversion factor× 33.4009

Office rate, Delaware$263.68

Office: (2.54 × 1.005 + 5.07 × 0.988 + 0.37 × 0.899) × $33.4009 = $263.68

Facility: (2.54 × 1.005 + 1.23 × 0.988 + 0.37 × 0.899) × $33.4009 = $136.96

Open 31237 in the RVU calculator

Payment rules and modifiers for 31237

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

CMS payment indicators · 31237

Nasal endoscopy, biopsy, polypectomy, or debridement

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

31237 without 50 · national office

$266.54

Nasal endoscopy, biopsy, polypectomy, or debridement

31237-50 · Bilateral: 150%

$399.81

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).

When to use modifier 50

Codes related to 31237

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

Codes related to 31237
CodeHow it relatesOffice range, Delaware
Used instead
31231Nasal endoscopy, diagnostic, without sinusoscopyDiagnostic nasal endoscopy is the closer choice when the encounter involves inspection without biopsy, polypectomy, or debridement.$191.20
31233Sinus endoscopy, maxillary sinusA diagnostic endoscopy that includes maxillary sinus evaluation may fit when no tissue treatment is performed.$269.60
31235Sinus endoscopy, diagnostic sphenoid sinusoscopyA diagnostic endoscopy that includes sphenoid sinus evaluation may fit when no tissue treatment is performed.$306.93

How 31237 has changed in Delaware

31237 · Office / nonfacility

$263.68

Effective 2026-10-01

The base rate is $7.37 higher than on 2025-10-01, moving from $256.31 to $263.68 (2.9%).

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

    $256.31changed to$263.68

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.60 changed to 2.54
    • Practice expense RVU 4.97 changed to 5.07
    • Malpractice RVU 0.39 changed to 0.37
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $256.51changed to$256.31

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.76 changed to 4.97
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $252.32changed to$256.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $262.58changed to$252.32

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.75 changed to 4.76
    • Malpractice RVU 0.37 changed to 0.38
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $267.11changed to$262.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.66 changed to 4.75
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $265.43changed to$267.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.56 changed to 4.66
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $264.29changed to$265.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.26 changed to 4.56
    • Malpractice RVU 0.35 changed to 0.36
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $266.82changed to$264.29

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.29 changed to 4.26
    • Malpractice RVU 0.37 changed to 0.35
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $272.77changed to$266.82

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.46 changed to 4.29

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $268.88changed to$272.77

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.35 changed to 4.46
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $272.45changed to$268.88

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.44 changed to 4.35
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $271.96changed to$272.45

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.40 changed to 4.44

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $270.60changed to$271.96

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $269.05changed to$270.60

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.43 changed to 4.40
    • Malpractice RVU 0.32 changed to 0.37
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $342.88changed to$269.05

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 2.98 changed to 2.60
    • Practice expense RVU 6.52 changed to 4.43
    • Malpractice RVU 0.38 changed to 0.32
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $342.88

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$263.68$136.96RVU26D
2026-07-01$263.68$136.96RVU26C
2026-04-01$263.68$136.96RVU26B
2026-01-01$263.68$136.96RVU26A
2025-10-01$256.31$155.87RVU25D
2025-07-01$256.31$155.87RVU25C
2025-04-01$256.31$155.87RVU25B
2025-01-01$256.31$155.87RVU25A
2024-10-01$256.51$159.10RVU24D
2024-07-01$256.51$159.10RVU24C
2024-04-01$256.51$159.10RVU24B
2024-03-09$256.51$159.10RVU24AR
2024-01-01$252.32$156.50RVU24A
2023-10-01$262.58$161.57RVU23D
2023-07-01$262.58$161.57RVU23C
2023-04-01$262.58$161.57RVU23B
2023-01-01$262.58$161.57RVU23A
2022-10-01$267.11$162.77RVU22D
2022-07-01$267.11$162.77RVU22C
2022-04-01$267.11$162.77RVU22B
2022-01-01$267.11$162.77RVU22A
2021-10-01$265.43$161.66RVU21D
2021-07-01$265.43$161.66RVU21C
2021-04-01$265.43$161.66RVU21B
2021-01-01$265.43$161.66RVU21A
2020-10-01$264.29$165.91RVU20D
2020-07-01$264.29$165.91RVU20C
2020-04-01$264.29$165.91RVU20B
2020-01-01$264.29$165.91RVU20A
2019-10-01$266.82$168.40RVU19D
2019-07-01$266.82$168.40RVU19C
2019-04-01$266.82$168.40RVU19B
2019-01-01$266.82$168.40RVU19A
2018-10-01$272.77$167.49RVU18D
2018-07-01$272.77$167.49RVU18C
2018-04-01$272.77$167.49RVU18B
2018-01-01$272.77$167.49RVU18AR1
2017-10-01$268.88$169.19RVU17D
2017-07-01$268.88$169.19RVU17C
2017-04-01$268.88$169.19RVU17B
2017-01-01$268.88$169.19RVU17A
2016-10-01$272.45$170.94RVU16D
2016-07-01$272.45$170.94RVU16C
2016-04-01$272.45$170.94RVU16B
2016-01-01$272.45$170.94RVU16A
2015-10-01$271.96$170.82RVU15D
2015-07-01$271.96$170.82RVU15C
2015-04-01$270.60$169.97RVU15B
2015-01-01$270.60$169.97RVU15A
2014-10-01$269.05$168.65RVU14D
2014-07-01$269.05$168.65RVU14C
2014-04-01$269.05$168.65RVU14B
2014-01-01$269.05$168.65RVU14A
2013-10-01$342.88$183.04RVU13D
2013-07-01$342.88$183.04RVU13C
2013-04-01$342.88$183.04RVU13B
2013-01-01$342.88$183.04RVU13AR

Price 31237 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

31237 billing questions

When is this code appropriate instead of diagnostic nasal endoscopy?

Use this code when endoscopy includes a biopsy, polypectomy, or debridement. Inspection and evaluation without one of those therapeutic or tissue-sampling services may support a diagnostic endoscopy code instead.

Can this code describe postoperative sinus debridement?

Yes, when the physician performs endoscopic debridement, such as clearing crusts, clots, or devitalized tissue. Document the treated area and the work performed.

How is bilateral treatment reported?

CMS identifies this as a bilateral procedure. Report modifier 50 for bilateral work; CMS payment is 150%.

What happens when related endoscopies are performed together?

CMS applies endoscopy-family pricing when related endoscopies are performed together. The medical record should identify each procedure and its distinct purpose and site.

Is same-day postoperative care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care. A debridement performed on a later date is not within that same-day global period.

Can an assistant surgeon or co-surgeon be reported?

An assistant at surgery is not paid under the statutory restriction. CMS does not permit co-surgeons or team surgery for this procedure.

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 31237PPRRVU2026_Oct_nonQPP.csv, line 3,527 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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