CPT code 31238: Nasal endoscopy, hemorrhage control2026 Medicare rate & RVUs

Medicare pays $260.19 for 31238 nationally in the office and $144.29 in a hospital or facility. Local office rates run $231.60–$333.79.

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

What 31238 covers

An otolaryngologist typically uses a nasal endoscope to find and treat a bleeding site, often when epistaxis persists despite packing or other initial measures. The surgeon may cauterize or otherwise surgically control the source. The procedure is commonly performed in an operating room or procedure setting, with anesthesia as clinically appropriate.

Report this code when the documented service is endoscopic surgical control of nasal bleeding, rather than diagnostic inspection alone or control performed without endoscopy. The record should describe the bleeding site, side, operative method, and reason for intervention. This minor procedure 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. Modifier 50 identifies bilateral services and is paid at 150%. An assistant is paid only when medical necessity is documented; 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 31238 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

31238 rates by state

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

How the 31238 rate is calculated

Each of 31238’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 31238

The CMS indicators that decide how 31238 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

31238 compared with similar codes

How to choose

31231Nasal endoscopyDiagnostic, without sinusoscopy

31231 is diagnostic nasal endoscopy. Choose 31238 when the endoscopic encounter includes surgical treatment of nasal hemorrhage.

31241Artery ligationEndoscopic epistaxis control

31241 identifies endoscopic ligation of the sphenopalatine artery. Use it when that specific operation is performed, rather than reporting general endoscopic hemorrhage control.

30903Nosebleed controlComplex anterior treatment

30903 describes complex anterior nasal bleeding control without the endoscopic surgical approach represented by 31238.

30905Nosebleed controlPosterior, initial treatment

30905 describes nonendoscopic control of posterior nasal bleeding; 31238 requires endoscopic surgical control.

Codes related to 31238

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