CPT code 31253: Sinus endoscopy, total ethmoidectomy and frontal exploration2026 Medicare rate & RVUs in New Mexico
Report this endoscopic sinus operation when the surgeon performs a total ethmoidectomy and explores the frontal sinus during the same procedure.
In New Mexico, Medicare pays $421.89 for 31253 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 31253 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 31253 covers
An otolaryngologist uses an endoscope through the nostril to remove ethmoid air cells as a total ethmoidectomy and access the frontal sinus. Frontal sinus tissue may also be removed when encountered. The operation is used for conditions such as chronic rhinosinusitis with obstructed frontal drainage or nasal polyps, and is typically performed in an operating room.
Select 31253 when the operative report supports both the total ethmoidectomy and frontal sinus exploration; document the work performed on each side. CMS applies endoscopy-family pricing when related endoscopies are performed together. For bilateral reporting, modifier 50 is paid at 150%. The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery for this service; 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 New Mexico compares for 31253
Across 109 of 109 payment localities, the facility rate for 31253 runs from $386.85 in Wisconsin to $552.92 in Alaska. New Mexico pays $421.89. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$421.89
- Los Angeles, CA · California$433.07+$11.18
- Washington, DC area · District of Columbia$455.81+$33.92
- Miami, FL · Florida$489.50+$67.61
- Chicago, IL · Illinois$478.45+$56.56
- Manhattan, NY · New York$477.78+$55.89
- Alaska · Alaska$552.92+$131.03
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $391.00 |
| ArkansasArkansas | — | $387.47 |
| ArizonaArizona | — | $411.38 |
| Bakersfield, CACalifornia | — | $416.96 |
| Chico, CACalifornia | — | $413.22 |
| El Centro, CACalifornia | — | $413.44 |
| Fresno, CACalifornia | — | $413.22 |
| Hanford, CACalifornia | — | $413.22 |
| Madera, CACalifornia | — | $413.22 |
| Merced, CACalifornia | — | $413.22 |
| Modesto, CACalifornia | — | $413.22 |
| Napa, CACalifornia | — | $444.12 |
| Oxnard, CACalifornia | — | $427.41 |
| Redding, CACalifornia | — | $413.22 |
| Rest of CaliforniaCalifornia | — | $413.22 |
| Riverside, CACalifornia | — | $427.18 |
| Sacramento, CACalifornia | — | $424.41 |
| Salinas, CACalifornia | — | $422.61 |
| San Diego, CACalifornia | — | $425.68 |
| Marin County, CACalifornia | — | $459.11 |
| San Francisco, CACalifornia | — | $457.64 |
| San Benito County, CACalifornia | — | $469.51 |
| Santa Clara County, CACalifornia | — | $463.52 |
| San Luis Obispo, CACalifornia | — | $416.83 |
| Santa Cruz, CACalifornia | — | $424.37 |
| Santa Maria, CACalifornia | — | $422.32 |
| Santa Rosa, CACalifornia | — | $428.10 |
| Stockton, CACalifornia | — | $413.22 |
| Vallejo, CACalifornia | — | $442.01 |
| Visalia, CACalifornia | — | $413.22 |
| Yuba City, CACalifornia | — | $413.22 |
| ColoradoColorado | — | $419.63 |
| ConnecticutConnecticut | — | $441.55 |
| DelawareDelaware | — | $416.29 |
| Fort Lauderdale, FLFlorida | — | $456.09 |
| Rest of FloridaFlorida | — | $438.17 |
| Atlanta, GAGeorgia | — | $431.07 |
| Rest of GeorgiaGeorgia | — | $419.40 |
| Hawaii, Guam, HIHawaii | — | $413.53 |
| IowaIowa | — | $387.08 |
| IdahoIdaho | — | $390.77 |
| East St. Louis, ILIllinois | — | $457.17 |
| Rest of IllinoisIllinois | — | $437.15 |
| Suburban Chicago, ILIllinois | — | $457.76 |
| IndianaIndiana | — | $391.92 |
| KansasKansas | — | $390.76 |
| KentuckyKentucky | — | $407.22 |
| New Orleans, LALouisiana | — | $421.10 |
| Rest of LouisianaLouisiana | — | $408.73 |
| Metropolitan Boston, MAMassachusetts | — | $443.73 |
| Rest of MassachusettsMassachusetts | — | $420.57 |
| Baltimore area, MDMaryland | — | $441.21 |
| Rest of MarylandMaryland | — | $420.59 |
| Rest of MaineMaine | — | $397.19 |
| Southern Maine, MEMaine | — | $403.53 |
| Detroit, MIMichigan | — | $446.81 |
| Rest of MichiganMichigan | — | $418.45 |
| MinnesotaMinnesota | — | $392.28 |
| Metropolitan Kansas City, MOMissouri | — | $414.08 |
| Metropolitan St. Louis, MOMissouri | — | $416.25 |
| Rest of MissouriMissouri | — | $407.49 |
| MississippiMississippi | — | $397.28 |
| MontanaMontana | — | $420.10 |
| North CarolinaNorth Carolina | — | $399.01 |
| North DakotaNorth Dakota | — | $394.59 |
| NebraskaNebraska | — | $386.93 |
| New HampshireNew Hampshire | — | $418.23 |
| Northern New JerseyNew Jersey | — | $455.00 |
| Rest of New JerseyNew Jersey | — | $443.81 |
| NevadaNevada | — | $413.07 |
| NYC suburbs and Long Island, NYNew York | — | $491.72 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $450.39 |
| Queens, NYNew York | — | $473.25 |
| Rest of New YorkNew York | — | $403.19 |
| OhioOhio | — | $413.23 |
| OklahomaOklahoma | — | $401.60 |
| Portland, OROregon | — | $423.15 |
| Rest of OregonOregon | — | $407.05 |
| Metropolitan Philadelphia, PAPennsylvania | — | $437.22 |
| Rest of PennsylvaniaPennsylvania | — | $410.94 |
| Puerto RicoPuerto Rico | — | $420.46 |
| Rhode IslandRhode Island | — | $423.87 |
| South CarolinaSouth Carolina | — | $407.35 |
| South DakotaSouth Dakota | — | $391.57 |
| TennesseeTennessee | — | $392.60 |
| Austin, TXTexas | — | $420.72 |
| Beaumont, TXTexas | — | $409.58 |
| Brazoria, TXTexas | — | $412.30 |
| Dallas, TXTexas | — | $416.37 |
| Fort Worth, TXTexas | — | $416.09 |
| Galveston, TXTexas | — | $414.53 |
| Houston, TXTexas | — | $438.14 |
| Rest of TexasTexas | — | $411.73 |
| UtahUtah | — | $410.76 |
| VirginiaVirginia | — | $406.09 |
| Virgin Islands, VIUnited States Virgin Islands | — | $420.46 |
| VermontVermont | — | $398.06 |
| Rest of WashingtonWashington | — | $418.14 |
| King County, WAWashington | — | $445.99 |
| WisconsinWisconsin | — | $386.85 |
| West VirginiaWest Virginia | — | $427.77 |
| WyomingWyoming | — | $408.98 |
31253 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 31253 rate is calculated
Each of 31253’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 · 31253
RVUs × geographic indexes × conversion factor
Work8.78
8.78 RVUs× 1.000 GPCI
Practice expense2.51
2.51 RVUs× 1.000 GPCI
Malpractice1.29
1.29 RVUs× 1.000 GPCI
Adjusted RVUs
12.5800
Conversion factor
$33.4009
Medicare rate
$420.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,534
- Code
- 31253
- Physician work
- 8.78
- Practice expense
- 2.51
- Malpractice
- 1.29
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.78 | × 1.000 | 8.7800 |
| Practice expense | 2.51 | × 0.917 | 2.3017 |
| Malpractice | 1.29 | × 1.201 | 1.5493 |
| Total RVUs | 12.6310 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$421.89
Facility: (8.78 × 1 + 2.51 × 0.917 + 1.29 × 1.201) × $33.4009 = $421.89
Payment rules and modifiers for 31253
The CMS indicators that decide how 31253 is paid alongside other services.
CMS payment indicators · 31253
Sinus endoscopy, total ethmoidectomy and frontal exploration
| 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) | 1 | Not paid (statutory restriction). |
| 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
31253 without 50 · national facility
$420.18
Sinus endoscopy, total ethmoidectomy and frontal exploration
31253-50 · Bilateral: 150%
$630.27
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 31253 has changed in New Mexico
31253 · 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 | $421.89 | RVU26D |
| 2026-07-01 | Not available in this setting | $421.89 | RVU26C |
| 2026-04-01 | Not available in this setting | $421.89 | RVU26B |
| 2026-01-01 | Not available in this setting | $421.89 | RVU26A |
| 2025-10-01 | Not available in this setting | $476.09 | RVU25D |
| 2025-07-01 | Not available in this setting | $476.09 | RVU25C |
| 2025-04-01 | Not available in this setting | $476.09 | RVU25B |
| 2025-01-01 | Not available in this setting | $476.09 | RVU25A |
| 2024-10-01 | Not available in this setting | $488.82 | RVU24D |
| 2024-07-01 | Not available in this setting | $488.82 | RVU24C |
| 2024-04-01 | Not available in this setting | $488.82 | RVU24B |
| 2024-03-09 | Not available in this setting | $488.82 | RVU24AR |
| 2024-01-01 | Not available in this setting | $480.84 | RVU24A |
| 2023-10-01 | Not available in this setting | $495.99 | RVU23D |
| 2023-07-01 | Not available in this setting | $495.99 | RVU23C |
| 2023-04-01 | Not available in this setting | $495.99 | RVU23B |
| 2023-01-01 | Not available in this setting | $495.99 | RVU23A |
| 2022-10-01 | Not available in this setting | $500.56 | RVU22D |
| 2022-07-01 | Not available in this setting | $500.56 | RVU22C |
| 2022-04-01 | Not available in this setting | $500.56 | RVU22B |
| 2022-01-01 | Not available in this setting | $500.56 | RVU22A |
| 2021-10-01 | Not available in this setting | $498.08 | RVU21D |
| 2021-07-01 | Not available in this setting | $498.08 | RVU21C |
| 2021-04-01 | Not available in this setting | $498.08 | RVU21B |
| 2021-01-01 | Not available in this setting | $498.08 | RVU21A |
| 2020-10-01 | Not available in this setting | $515.14 | RVU20D |
| 2020-07-01 | Not available in this setting | $515.14 | RVU20C |
| 2020-04-01 | Not available in this setting | $515.14 | RVU20B |
| 2020-01-01 | Not available in this setting | $515.14 | RVU20A |
| 2019-10-01 | Not available in this setting | $519.95 | RVU19D |
| 2019-07-01 | Not available in this setting | $519.95 | RVU19C |
| 2019-04-01 | Not available in this setting | $519.95 | RVU19B |
| 2019-01-01 | Not available in this setting | $519.95 | RVU19A |
| 2018-10-01 | Not available in this setting | $517.63 | RVU18D |
| 2018-07-01 | Not available in this setting | $517.63 | RVU18C |
| 2018-04-01 | Not available in this setting | $517.63 | RVU18B |
| 2018-01-01 | Not available in this setting | $517.63 | 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 New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
31253 billing questions
When should 31253 be chosen instead of 31255?
Use 31253 when the surgeon performs a total ethmoidectomy and frontal sinus exploration. Code 31255 describes a total ethmoidectomy without the frontal sinus work.
Can 31255 or 31276 also be reported for the same operative work?
Do not separately report those codes for the total ethmoidectomy or frontal exploration already represented by 31253. CMS endoscopy-family pricing applies when related endoscopies are performed together.
How is bilateral 31253 reported?
Report modifier 50 for bilateral surgery; CMS pays the bilateral procedure at 150%. Document the work performed on both sides.
Does 31253 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can an assistant surgeon or co-surgeon be paid for 31253?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
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