CPT code 31287: Sphenoidotomy, without tissue removal2026 Medicare rate & RVUs in California
Reports endoscopic opening of the sphenoid sinus to improve drainage, without removing tissue from that sinus.
CMS doesn’t publish an office rate for 31287 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 31287 covers
An otolaryngologist typically performs this procedure through the nasal passages, using an endoscope to open the sphenoid sinus. It may be performed for sphenoid sinus disease when the surgeon needs to establish or improve drainage but does not remove tissue from the sinus. The operative report should identify the sphenoid sinus treated and describe the surgical opening; tissue removal from that sinus points to a different code.
Report the service for the sphenoidotomy itself, not as a substitute for a more extensive procedure that includes ethmoid surgery or sphenoid tissue removal. 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 work, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 31287 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $170.12 |
| Chico, CA | Unavailable | $168.72 |
| El Centro, CA | Unavailable | $168.80 |
| Fresno, CA | Unavailable | $168.72 |
| Hanford, CA | Unavailable | $168.72 |
| Los Angeles, CA | Unavailable | $177.02 |
| Madera, CA | Unavailable | $168.72 |
| Marin County, CA | Unavailable | $189.06 |
| Merced, CA | Unavailable | $168.72 |
| Modesto, CA | Unavailable | $168.72 |
| Napa, CA | Unavailable | $182.48 |
| Oxnard, CA | Unavailable | $174.85 |
| Redding, CA | Unavailable | $168.72 |
| Rest of California | Unavailable | $168.72 |
| Riverside, CA | Unavailable | $173.92 |
| Sacramento, CA | Unavailable | $173.59 |
| Salinas, CA | Unavailable | $172.86 |
| San Benito County, CA | Unavailable | $193.30 |
| San Diego, CA | Unavailable | $174.34 |
| San Francisco, CA | Unavailable | $188.52 |
| San Luis Obispo, CA | Unavailable | $170.46 |
| Santa Clara County, CA | Unavailable | $191.07 |
| Santa Cruz, CA | Unavailable | $173.99 |
| Santa Maria, CA | Unavailable | $172.80 |
| Santa Rosa, CA | Unavailable | $175.54 |
| Stockton, CA | Unavailable | $168.72 |
| Vallejo, CA | Unavailable | $181.70 |
| Visalia, CA | Unavailable | $168.72 |
| Yuba City, CA | Unavailable | $168.72 |
How the 31287 rate is calculated
Each of 31287’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 · 31287
RVUs × geographic indexes × conversion factor
Work3.41
3.41 RVUs× 1.000 GPCI
Practice expense1.21
1.21 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
5.1000
Conversion factor
$33.4009
Medicare rate
$170.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31287
The CMS indicators that decide how 31287 is paid alongside other services.
CMS payment indicators · 31287
Sphenoidotomy, without tissue removal
| 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
31287 without 50 · national facility
$170.34
Sphenoidotomy, without tissue removal
31287-50 · Bilateral: 150%
$255.51
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).
31287 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31288Sphenoid surgerySphenoid tissue removal
- 31287 is for sphenoidotomy without tissue removal from that sinus; 31288 includes sphenoid tissue removal.
- 31257Sinus endoscopyTotal ethmoidectomy and sphenoidotomy
- 31257 includes total ethmoid surgery with sphenoidotomy, while 31287 describes sphenoidotomy alone.
- 31297Sinus dilationSphenoid ostium
- 31297 describes balloon dilation of the sphenoid sinus ostium; 31287 is a surgical sphenoidotomy.
31287 billing questions
When should 31287 be chosen over 31288?
Use 31287 when the sphenoid sinus is surgically opened without tissue removal from that sinus. When tissue is removed from the sphenoid sinus, consider 31288 instead.
How does 31287 differ from 31257?
31287 covers sphenoidotomy alone. 31257 includes total ethmoid surgery along with sphenoidotomy.
Can modifier 50 be reported for bilateral sphenoidotomy?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Is same-day postoperative care included?
Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment is allowed only with documentation of medical necessity. 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
Fee sheets · Coming soon
Put 31287 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist