CPT code 31256: Maxillary antrostomy, without tissue removal2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $152.83 for 31256 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 31256 nationwide

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

What 31256 covers

An otolaryngologist typically performs this endoscopic procedure through the nasal passage to create or enlarge an opening into a maxillary sinus, improving access and drainage. It is used in surgical treatment of conditions such as chronic maxillary sinusitis when an operative antrostomy is performed. The code describes the sinus opening, not removal of tissue from within the maxillary sinus.

Select this code when the operative report supports a surgical maxillary antrostomy without maxillary sinus tissue removal; use the tissue-removal sibling when tissue is removed from the sinus. Document the side, the work performed, and whether sinus tissue was removed. The 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. For bilateral work, modifier 50 is paid at 150%. Medicare 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.

How Puerto Rico compares for 31256

Across 109 of 109 payment localities, the facility rate for 31256 runs from $140.45 in Arkansas to $199.21 in Alaska. Puerto Rico pays $152.83. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

31256 rates by state

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

See 31256 in every payment locality

How the 31256 rate is calculated

Each of 31256’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 31256

The CMS indicators that decide how 31256 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

Codes related to 31256

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

How 31256 has changed in Puerto Rico

Price 31256 for an earlier date of service

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

Browse all communities in Puerto Rico

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