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CPT code 31241: Artery ligation, endoscopic epistaxis control2026 Medicare rate & RVUs

Reports endoscopic ligation of the sphenopalatine artery to control significant posterior nasal bleeding, typically when less invasive measures have not controlled epistaxis.

CMS RVU26DEffective Oct 1, 2026109 payment localities359 Medicare services in 2024

Medicare pays $373.09 for 31241 nationally in a facility.

Medicare rate · 31241

Artery ligation, endoscopic epistaxis control

Office or facility?

Work RVUs
7.8
Total RVUs
11.17
Global days
000

National rate · 2026

$373.09

Facility setting, before claim adjustments.

See every locality for 31241 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 31241 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 31241 covers

An otolaryngologist uses a nasal endoscope to reach and ligate the sphenopalatine artery for surgical control of posterior epistaxis. The procedure is commonly performed in a facility operating room when bleeding has persisted or recurred despite measures such as packing or cautery. The operative report should identify the endoscopic approach, the artery ligated, the side treated, and the indication for definitive surgical control.

Report this code for the endoscopic artery-ligation service, not for diagnostic inspection alone or packing alone. CMS assigns 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 surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeon and team-surgery payment 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 31241 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

31241 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$347.25
AlaskaUnavailable$491.10
ArizonaUnavailable$365.30
ArkansasUnavailable$344.12
Atlanta, GAUnavailable$382.71
Austin, TXUnavailable$373.59
Bakersfield, CAUnavailable$370.30
Baltimore area, MDUnavailable$391.72
Beaumont, TXUnavailable$363.68
Brazoria, TXUnavailable$366.12

31241 rates by state

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

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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.

View every state and territory as a table
31241 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 31241 rate is calculated

Each of 31241’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 · 31241

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.80

7.80 RVUs× 1.000 GPCI

Practice expense2.23

2.23 RVUs× 1.000 GPCI

Malpractice1.14

1.14 RVUs× 1.000 GPCI

Adjusted RVUs

11.1700

Conversion factor

$33.4009

Medicare rate

$373.09

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

Payment rules and modifiers for 31241

The CMS indicators that decide how 31241 is paid alongside other services.

CMS payment indicators · 31241

Artery ligation, endoscopic epistaxis control

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)0Not paid without supporting documentation.
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

31241 without 50 · national facility

$373.09

Artery ligation, endoscopic epistaxis control

31241-50 · Bilateral: 150%

$559.63

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

31241 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 31241

    Artery ligation, endoscopic epistaxis control7.8 wRVU

    Not priced

  • 31238

    Nasal endoscopy, hemorrhage control2.67 wRVU

    $260.19

  • 30905

    Nosebleed control, posterior, initial treatment1.92 wRVU

    $395.47

  • 31231

    Nasal endoscopy, diagnostic, without sinusoscopy1.07 wRVU

    $193.39

How to choose

31238Nasal endoscopyHemorrhage control
Use 31241 when the surgeon ligates the sphenopalatine artery endoscopically. Code 31238 describes endoscopic control of nasal hemorrhage without specifying that artery ligation.
30905Nosebleed controlPosterior, initial treatment
Code 30905 is for initial posterior nasal hemorrhage control with packing or cautery. Code 31241 describes endoscopic surgical ligation of the sphenopalatine artery.
31231Nasal endoscopyDiagnostic, without sinusoscopy
Code 31231 is diagnostic nasal endoscopy. It does not describe the endoscopic surgical ligation used to control posterior epistaxis under 31241.

Codes related to 31241

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

Codes related to 31241
CodeHow it relatesNational office range
Used instead
31238Nasal endoscopy, hemorrhage controlEndoscopic control of nasal hemorrhage when sphenopalatine artery ligation is not the documented procedure.$231.60–$333.79
30905Nosebleed control, posterior, initial treatmentPosterior nasal hemorrhage control using packing or cautery rather than endoscopic artery ligation.$344.27–$537.17
30906Nosebleed control, posterior, subsequent treatmentSubsequent posterior nasal hemorrhage control, rather than definitive endoscopic artery ligation.$356.06–$547.61

31241 billing questions

How does this differ from 31238?

31241 identifies endoscopic ligation of the sphenopalatine artery. Use 31238 for endoscopic control of nasal hemorrhage when the documented procedure is not this specified artery ligation.

Can nasal packing be reported with this procedure?

Packing alone is not the artery-ligation service described by 31241. The operative documentation should establish that the sphenopalatine artery was ligated endoscopically.

How should bilateral ligation be reported?

For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.

Is an assistant surgeon payable?

Assistant-at-surgery payment is allowed only when the record documents medical necessity. CMS does not permit co-surgeon or team-surgery payment for this code.

What is included in the global period?

The code has a 0-day global period. Same-day preoperative and postoperative care is included.

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 31241PPRRVU2026_Oct_nonQPP.csv, line 3,531 (RVU26D)

Open CMS sourceHow we calculate rates

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