CPT code 31241: Artery ligation, endoscopic epistaxis control2026 Medicare rate & RVUs in Puerto Rico
Reports endoscopic ligation of the sphenopalatine artery to control significant posterior nasal bleeding, typically when less invasive measures have not controlled epistaxis.
In Puerto Rico, Medicare pays $373.34 for 31241 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 31241 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 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.
How Puerto Rico compares for 31241
Across 109 of 109 payment localities, the facility rate for 31241 runs from $343.61 in Wisconsin to $491.10 in Alaska. Puerto Rico pays $373.34. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$373.34
- Los Angeles, CA · California$384.61+$11.27
- Washington, DC area · District of Columbia$404.72+$31.38
- Miami, FL · Florida$434.36+$61.02
- Chicago, IL · Illinois$424.59+$51.25
- Manhattan, NY · New York$424.14+$50.80
- Alaska · Alaska$491.10+$117.76
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $347.25 |
| ArkansasArkansas | — | $344.12 |
| ArizonaArizona | — | $365.30 |
| Bakersfield, CACalifornia | — | $370.30 |
| Chico, CACalifornia | — | $367.00 |
| El Centro, CACalifornia | — | $367.19 |
| Fresno, CACalifornia | — | $367.00 |
| Hanford, CACalifornia | — | $367.00 |
| Madera, CACalifornia | — | $367.00 |
| Merced, CACalifornia | — | $367.00 |
| Modesto, CACalifornia | — | $367.00 |
| Napa, CACalifornia | — | $394.45 |
| Oxnard, CACalifornia | — | $379.58 |
| Redding, CACalifornia | — | $367.00 |
| Rest of CaliforniaCalifornia | — | $367.00 |
| Riverside, CACalifornia | — | $379.33 |
| Sacramento, CACalifornia | — | $376.94 |
| Salinas, CACalifornia | — | $375.34 |
| San Diego, CACalifornia | — | $378.06 |
| Marin County, CACalifornia | — | $407.78 |
| San Francisco, CACalifornia | — | $406.48 |
| San Benito County, CACalifornia | — | $417.00 |
| Santa Clara County, CACalifornia | — | $411.71 |
| San Luis Obispo, CACalifornia | — | $370.20 |
| Santa Cruz, CACalifornia | — | $376.91 |
| Santa Maria, CACalifornia | — | $375.08 |
| Santa Rosa, CACalifornia | — | $380.22 |
| Stockton, CACalifornia | — | $367.00 |
| Vallejo, CACalifornia | — | $392.59 |
| Visalia, CACalifornia | — | $367.00 |
| Yuba City, CACalifornia | — | $367.00 |
| ColoradoColorado | — | $372.64 |
| ConnecticutConnecticut | — | $392.03 |
| DelawareDelaware | — | $369.65 |
| Fort Lauderdale, FLFlorida | — | $404.82 |
| Rest of FloridaFlorida | — | $388.96 |
| Atlanta, GAGeorgia | — | $382.71 |
| Rest of GeorgiaGeorgia | — | $372.35 |
| Hawaii, Guam, HIHawaii | — | $367.26 |
| IowaIowa | — | $343.80 |
| IdahoIdaho | — | $347.06 |
| East St. Louis, ILIllinois | — | $405.74 |
| Rest of IllinoisIllinois | — | $388.05 |
| Suburban Chicago, ILIllinois | — | $406.32 |
| IndianaIndiana | — | $348.08 |
| KansasKansas | — | $347.05 |
| KentuckyKentucky | — | $361.58 |
| New Orleans, LALouisiana | — | $373.87 |
| Rest of LouisianaLouisiana | — | $362.92 |
| Metropolitan Boston, MAMassachusetts | — | $394.03 |
| Rest of MassachusettsMassachusetts | — | $373.47 |
| Baltimore area, MDMaryland | — | $391.72 |
| Rest of MarylandMaryland | — | $373.46 |
| Rest of MaineMaine | — | $352.74 |
| Southern Maine, MEMaine | — | $358.37 |
| Detroit, MIMichigan | — | $396.60 |
| Rest of MichiganMichigan | — | $371.52 |
| MinnesotaMinnesota | — | $348.44 |
| Metropolitan Kansas City, MOMissouri | — | $367.67 |
| Metropolitan St. Louis, MOMissouri | — | $369.59 |
| Rest of MissouriMissouri | — | $361.82 |
| MississippiMississippi | — | $352.80 |
| MontanaMontana | — | $373.01 |
| North CarolinaNorth Carolina | — | $354.35 |
| North DakotaNorth Dakota | — | $350.47 |
| NebraskaNebraska | — | $343.67 |
| New HampshireNew Hampshire | — | $371.38 |
| Northern New JerseyNew Jersey | — | $404.01 |
| Rest of New JerseyNew Jersey | — | $394.06 |
| New MexicoNew Mexico | — | $374.56 |
| NevadaNevada | — | $366.80 |
| NYC suburbs and Long Island, NYNew York | — | $436.47 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $399.88 |
| Queens, NYNew York | — | $420.15 |
| Rest of New YorkNew York | — | $358.05 |
| OhioOhio | — | $366.91 |
| OklahomaOklahoma | — | $356.63 |
| Portland, OROregon | — | $375.78 |
| Rest of OregonOregon | — | $361.48 |
| Metropolitan Philadelphia, PAPennsylvania | — | $388.18 |
| Rest of PennsylvaniaPennsylvania | — | $364.89 |
| Rhode IslandRhode Island | — | $376.38 |
| South CarolinaSouth Carolina | — | $361.72 |
| South DakotaSouth Dakota | — | $347.80 |
| TennesseeTennessee | — | $348.68 |
| Austin, TXTexas | — | $373.59 |
| Beaumont, TXTexas | — | $363.68 |
| Brazoria, TXTexas | — | $366.12 |
| Dallas, TXTexas | — | $369.73 |
| Fort Worth, TXTexas | — | $369.48 |
| Galveston, TXTexas | — | $368.10 |
| Houston, TXTexas | — | $388.97 |
| Rest of TexasTexas | — | $365.60 |
| UtahUtah | — | $364.74 |
| VirginiaVirginia | — | $360.63 |
| Virgin Islands, VIUnited States Virgin Islands | — | $373.34 |
| VermontVermont | — | $353.53 |
| Rest of WashingtonWashington | — | $371.32 |
| King County, WAWashington | — | $396.05 |
| WisconsinWisconsin | — | $343.61 |
| West VirginiaWest Virginia | — | $379.74 |
| WyomingWyoming | — | $363.19 |
31241 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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,531
- Code
- 31241
- Physician work
- 7.80
- Practice expense
- 2.23
- Malpractice
- 1.14
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.80 | × 1.000 | 7.8000 |
| Practice expense | 2.23 | × 1.011 | 2.2545 |
| Malpractice | 1.14 | × 0.985 | 1.1229 |
| Total RVUs | 11.1774 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Puerto Rico$373.34
Facility: (7.8 × 1 + 2.23 × 1.011 + 1.14 × 0.985) × $33.4009 = $373.34
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
| 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
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).
How 31241 has changed in Puerto Rico
31241 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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, 2018
RVU18AR1
No ratechanged toNo rate
Held through RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $373.34 | RVU26D |
| 2026-07-01 | Not available in this setting | $373.34 | RVU26C |
| 2026-04-01 | Not available in this setting | $373.34 | RVU26B |
| 2026-01-01 | Not available in this setting | $373.34 | RVU26A |
| 2025-10-01 | Not available in this setting | $429.17 | RVU25D |
| 2025-07-01 | Not available in this setting | $429.17 | RVU25C |
| 2025-04-01 | Not available in this setting | $429.17 | RVU25B |
| 2025-01-01 | Not available in this setting | $429.17 | RVU25A |
| 2024-10-01 | Not available in this setting | $441.95 | RVU24D |
| 2024-07-01 | Not available in this setting | $441.95 | RVU24C |
| 2024-04-01 | Not available in this setting | $441.95 | RVU24B |
| 2024-03-09 | Not available in this setting | $441.95 | RVU24AR |
| 2024-01-01 | Not available in this setting | $434.74 | RVU24A |
| 2023-10-01 | Not available in this setting | $448.14 | RVU23D |
| 2023-07-01 | Not available in this setting | $447.65 | RVU23C |
| 2023-04-01 | Not available in this setting | $447.65 | RVU23B |
| 2023-01-01 | Not available in this setting | $447.65 | RVU23A |
| 2022-10-01 | Not available in this setting | $452.16 | RVU22D |
| 2022-07-01 | Not available in this setting | $452.16 | RVU22C |
| 2022-04-01 | Not available in this setting | $452.16 | RVU22B |
| 2022-01-01 | Not available in this setting | $452.16 | RVU22A |
| 2021-10-01 | Not available in this setting | $449.94 | RVU21D |
| 2021-07-01 | Not available in this setting | $449.94 | RVU21C |
| 2021-04-01 | Not available in this setting | $449.94 | RVU21B |
| 2021-01-01 | Not available in this setting | $449.94 | RVU21A |
| 2020-10-01 | Not available in this setting | $461.45 | RVU20D |
| 2020-07-01 | Not available in this setting | $461.45 | RVU20C |
| 2020-04-01 | Not available in this setting | $461.45 | RVU20B |
| 2020-01-01 | Not available in this setting | $461.45 | RVU20A |
| 2019-10-01 | Not available in this setting | $463.23 | RVU19D |
| 2019-07-01 | Not available in this setting | $463.23 | RVU19C |
| 2019-04-01 | Not available in this setting | $463.23 | RVU19B |
| 2019-01-01 | Not available in this setting | $463.23 | RVU19A |
| 2018-10-01 | Not available in this setting | $462.35 | RVU18D |
| 2018-07-01 | Not available in this setting | $462.35 | RVU18C |
| 2018-04-01 | Not available in this setting | $462.35 | RVU18B |
| 2018-01-01 | Not available in this setting | $462.35 | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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
Fee sheets · Coming soon
Put 31241 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist