CPT code 31287: Sphenoidotomy, without tissue removal2026 Medicare rate & RVUs in New Mexico

Reports endoscopic opening of the sphenoid sinus to improve drainage, without removing tissue from that sinus.

CMS RVU26DEffective Oct 1, 2026One payment locality2.1K Medicare services in 2024

In New Mexico, Medicare pays $170.21 for 31287 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$170.21Hospital or facility

Check a contract rate as a % of Medicare · 31287 nationwide

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

We’ll open 31287 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 31287 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How New Mexico compares for 31287

Across 109 of 109 payment localities, the facility rate for 31287 runs from $156.87 in Arkansas to $222.72 in Alaska. New Mexico pays $170.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

31287 in New Mexico vs other payment areas
  1. New Mexico · this page$170.21
  2. Los Angeles, CA · California$177.02+$6.81
  3. Washington, DC area · District of Columbia$185.50+$15.29
  4. Miami, FL · Florida$196.52+$26.31
  5. Chicago, IL · Illinois$192.11+$21.90
  6. Manhattan, NY · New York$193.58+$23.37
  7. Alaska · Alaska$222.72+$52.51

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

31287 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$158.33
ArkansasArkansas—$156.87
ArizonaArizona—$166.78
Bakersfield, CACalifornia—$170.12
Chico, CACalifornia—$168.72
El Centro, CACalifornia—$168.80
Fresno, CACalifornia—$168.72
Hanford, CACalifornia—$168.72

31287 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

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31287 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 31287 in every payment locality

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

Office or facility?

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.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,543

Code
31287
Physician work
3.41
Practice expense
1.21
Malpractice
0.48

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 31287 in New Mexico
ComponentRVULocality factorAdjusted
Physician work3.41× 1.0003.4100
Practice expense1.21× 0.9171.1096
Malpractice0.48× 1.2010.5765
Total RVUs5.0960
Conversion factor× 33.4009

Facility rate, New Mexico$170.21

Facility: (3.41 × 1 + 1.21 × 0.917 + 0.48 × 1.201) × $33.4009 = $170.21

Open 31287 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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).

When to use modifier 50

How 31287 has changed in New Mexico

31287 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$170.21RVU26D
2026-07-01Not available in this setting$170.21RVU26C
2026-04-01Not available in this setting$170.21RVU26B
2026-01-01Not available in this setting$170.21RVU26A
2025-10-01Not available in this setting$191.79RVU25D
2025-07-01Not available in this setting$191.79RVU25C
2025-04-01Not available in this setting$191.79RVU25B
2025-01-01Not available in this setting$191.79RVU25A
2024-10-01Not available in this setting$196.46RVU24D
2024-07-01Not available in this setting$196.46RVU24C
2024-04-01Not available in this setting$196.46RVU24B
2024-03-09Not available in this setting$196.46RVU24AR
2024-01-01Not available in this setting$193.26RVU24A
2023-10-01Not available in this setting$199.54RVU23D
2023-07-01Not available in this setting$199.54RVU23C
2023-04-01Not available in this setting$199.54RVU23B
2023-01-01Not available in this setting$199.54RVU23A
2022-10-01Not available in this setting$200.83RVU22D
2022-07-01Not available in this setting$200.83RVU22C
2022-04-01Not available in this setting$200.83RVU22B
2022-01-01Not available in this setting$200.83RVU22A
2021-10-01Not available in this setting$199.18RVU21D
2021-07-01Not available in this setting$199.18RVU21C
2021-04-01Not available in this setting$199.18RVU21B
2021-01-01Not available in this setting$199.18RVU21A
2020-10-01Not available in this setting$206.21RVU20D
2020-07-01Not available in this setting$206.21RVU20C
2020-04-01Not available in this setting$206.21RVU20B
2020-01-01Not available in this setting$206.21RVU20A
2019-10-01Not available in this setting$208.35RVU19D
2019-07-01Not available in this setting$208.35RVU19C
2019-04-01Not available in this setting$208.35RVU19B
2019-01-01Not available in this setting$208.35RVU19A
2018-10-01Not available in this setting$207.46RVU18D
2018-07-01Not available in this setting$207.46RVU18C
2018-04-01Not available in this setting$207.46RVU18B
2018-01-01Not available in this setting$207.46RVU18AR1
2017-10-01Not available in this setting$236.17RVU17D
2017-07-01Not available in this setting$236.17RVU17C
2017-04-01Not available in this setting$236.17RVU17B
2017-01-01Not available in this setting$236.17RVU17A
2016-10-01Not available in this setting$236.65RVU16D
2016-07-01Not available in this setting$236.65RVU16C
2016-04-01Not available in this setting$236.65RVU16B
2016-01-01Not available in this setting$236.65RVU16A
2015-10-01Not available in this setting$237.17RVU15D
2015-07-01Not available in this setting$237.17RVU15C
2015-04-01Not available in this setting$235.99RVU15B
2015-01-01Not available in this setting$235.99RVU15A
2014-10-01Not available in this setting$233.93RVU14D
2014-07-01Not available in this setting$233.93RVU14C
2014-04-01Not available in this setting$233.93RVU14B
2014-01-01Not available in this setting$233.93RVU14A
2013-10-01Not available in this setting$227.28RVU13D
2013-07-01Not available in this setting$227.28RVU13C
2013-04-01Not available in this setting$227.28RVU13B
2013-01-01Not available in this setting$227.28RVU13AR

Price 31287 for an earlier date of service

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

Browse all communities in New Mexico

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
RVUs for 31287PPRRVU2026_Oct_nonQPP.csv, line 3,543 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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