CPT code 31257: Sinus endoscopy, total ethmoidectomy and sphenoidotomy2026 Medicare rate & RVUs in Utah

In Utah, Medicare pays $366.62 for 31257 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 31257 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 31257 covers

An otolaryngologist performs this endoscopic operation to remove ethmoid air-cell tissue from both the anterior and posterior portions of the ethmoid sinus and create an opening into the sphenoid sinus. It may be part of surgery for chronic rhinosinusitis when disease involves both sinus regions. The sphenoid sinus is opened, but removal of tissue from within that sinus is not part of this code’s distinguishing service.

Select the code when the operative report supports the complete ethmoidectomy and sphenoidotomy; distinguish it from a sphenoid procedure that also removes sphenoid tissue. Document the treated sides and the work performed in each sinus. 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 reporting, modifier 50 is paid at 150%. Medicare does not pay for an assistant at surgery, and 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 Utah compares for 31257

Across 109 of 109 payment localities, the facility rate for 31257 runs from $345.52 in Nebraska to $493.23 in Alaska. Utah pays $366.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

31257 rates by state

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

See 31257 in every payment locality

How the 31257 rate is calculated

Each of 31257’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 31257

The CMS indicators that decide how 31257 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

Codes related to 31257

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

How 31257 has changed in Utah

Price 31257 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

• Alpine
• Alta
• Altamont
• Alton
• Amalga
• American Fork
• Aneth
• Annabella

Browse all communities in Utah

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