CPT code 31255: Ethmoidectomy, total, anterior and posterior cells2026 Medicare rate & RVUs in Missouri
Endoscopic total ethmoidectomy removes disease from both anterior and posterior ethmoid air cells during operative treatment of ethmoid sinus disease.
CMS doesn’t publish an office rate for 31255 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 31255 covers
An otolaryngologist uses a nasal endoscope to operate on the ethmoid sinuses, removing the anterior and posterior ethmoid air cells. This procedure may be performed for chronic ethmoid sinus disease, including disease associated with nasal polyps, in a hospital or ambulatory surgical setting. The operative report should identify the side treated and document the extent of ethmoid dissection.
Report this code when the surgeon performs a total ethmoidectomy, rather than a partial ethmoidectomy. If the operation also includes frontal sinus exploration or sphenoid sinus surgery, select the applicable combined endoscopy code when its service is performed. CMS applies endoscopy family pricing when related endoscopies are performed together. For bilateral surgery, modifier 50 is paid at 150%. The 0-day global period includes same-day preoperative and postoperative care. CMS does not pay an assistant at surgery; 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 31255 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $269.02 |
| Metropolitan St. Louis, MO | Unavailable | $270.47 |
| Rest of Missouri | Unavailable | $264.44 |
How the 31255 rate is calculated
Each of 31255’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 · 31255
RVUs × geographic indexes × conversion factor
Work5.61
5.61 RVUs× 1.000 GPCI
Practice expense1.75
1.75 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
8.1800
Conversion factor
$33.4009
Medicare rate
$273.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31255
The CMS indicators that decide how 31255 is paid alongside other services.
CMS payment indicators · 31255
Ethmoidectomy, total, anterior and posterior cells
| 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
31255 without 50 · national facility
$273.22
Ethmoidectomy, total, anterior and posterior cells
31255-50 · Bilateral: 150%
$409.83
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).
31255 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31254EthmoidectomyPartial, anterior ethmoid
- Choose 31254 for partial ethmoidectomy. This code represents treatment of both anterior and posterior ethmoid cells.
- 31253Sinus endoscopyTotal ethmoidectomy and frontal exploration
- Choose 31253 when total ethmoidectomy is performed with frontal sinus exploration; use 31255 for total ethmoidectomy without that combination.
- 31257Sinus endoscopyTotal ethmoidectomy and sphenoidotomy
- Choose 31257 when total ethmoidectomy is combined with sphenoidotomy. This code covers the total ethmoidectomy alone.
- 31259Sinus endoscopyTotal ethmoidectomy, sphenoid tissue removal
- Choose 31259 when total ethmoidectomy is combined with sphenoidotomy and sphenoid tissue removal. This code does not describe that combined sphenoid service.
31255 billing questions
How do I distinguish this from 31254?
Use 31255 for a total ethmoidectomy involving anterior and posterior ethmoid cells. Code 31254 describes a partial ethmoidectomy.
What if frontal or sphenoid sinus surgery is also performed?
Check whether a combined code describes the total ethmoidectomy and the additional sinus work. Codes 31253, 31257, and 31259 cover specified combinations with frontal or sphenoid procedures.
What documentation supports reporting 31255?
The operative report should establish that the surgeon treated both anterior and posterior ethmoid cells and identify the side or sides operated on.
How is bilateral surgery handled under the CMS rules?
Report modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
Can an assistant or co-surgeon be reported?
CMS 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
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