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CPT code 31288: Sphenoid surgery, sphenoid tissue removal2026 Medicare rate & RVUs

Report this endoscopic sphenoid sinus operation when the surgeon opens the sinus and removes tissue, such as a polyp or diseased tissue.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.9K Medicare services in 2024

Medicare pays $198.07 for 31288 nationally in a facility.

Medicare rate · 31288

Sphenoid surgery, sphenoid tissue removal

Office or facility?

Work RVUs
4
Total RVUs
5.93
Global days
000

National rate · 2026

$198.07

Facility setting, before claim adjustments.

See every locality for 31288 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 31288 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 31288 covers

An otolaryngologist typically performs this endoscopic operation through the nasal passage to open the sphenoid sinus and remove tissue from within it. It may be performed for sphenoid disease when tissue, such as a polyp or diseased mucosa, is removed as part of the sinus procedure. The operative note should identify the sphenoid sinus treated, describe the opening and tissue removal, and record laterality and any additional sinus procedures.

Select this code when the sphenoid procedure includes tissue removal; a sphenoidotomy without tissue removal is a different service. CMS applies endoscopy-family pricing when related endoscopies are performed together. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For a bilateral procedure, 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 31288 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

31288 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$184.02
AlaskaUnavailable$259.10
ArizonaUnavailable$193.88
ArkansasUnavailable$182.31
Atlanta, GAUnavailable$203.08
Austin, TXUnavailable$198.74
Bakersfield, CAUnavailable$197.36
Baltimore area, MDUnavailable$208.09
Beaumont, TXUnavailable$192.63
Brazoria, TXUnavailable$194.47

31288 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.

View every state and territory as a table
31288 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

How the 31288 rate is calculated

Each of 31288’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 · 31288

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.00

4.00 RVUs× 1.000 GPCI

Practice expense1.35

1.35 RVUs× 1.000 GPCI

Malpractice0.58

0.58 RVUs× 1.000 GPCI

Adjusted RVUs

5.9300

Conversion factor

$33.4009

Medicare rate

$198.07

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 31288

The CMS indicators that decide how 31288 is paid alongside other services.

CMS payment indicators · 31288

Sphenoid surgery, sphenoid 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

31288 without 50 · national facility

$198.07

Sphenoid surgery, sphenoid tissue removal

31288-50 · Bilateral: 150%

$297.11

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

31288 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 31288

    Sphenoid surgery, sphenoid tissue removal4 wRVU

    Not priced

  • 31287

    Sphenoidotomy, without tissue removal3.41 wRVU

    Not priced

  • 31259

    Sinus endoscopy, total ethmoidectomy, sphenoid tissue removal8.27 wRVU

    Not priced

  • 31257

    Sinus endoscopy, total ethmoidectomy and sphenoidotomy7.8 wRVU

    Not priced

  • 31267

    Sinus endoscopy, maxillary tissue removal4.56 wRVU

    Not priced

How to choose

31287SphenoidotomyWithout tissue removal
31287 covers sphenoidotomy without tissue removal from the sphenoid sinus. Choose 31288 when the surgeon also removes tissue from that sinus.
31259Sinus endoscopyTotal ethmoidectomy, sphenoid tissue removal
31259 includes total ethmoidectomy along with sphenoidotomy and sphenoid tissue removal. Use 31288 for the sphenoid procedure without that included total ethmoidectomy.
31257Sinus endoscopyTotal ethmoidectomy and sphenoidotomy
31257 includes total ethmoidectomy and sphenoidotomy without sphenoid tissue removal. Code 31288 describes sphenoid tissue removal without the included ethmoidectomy.
31267Sinus endoscopyMaxillary tissue removal
31267 applies to maxillary sinus surgery with tissue removal; 31288 is for tissue removal from the sphenoid sinus.

Codes related to 31288

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

Codes related to 31288
CodeHow it relatesNational office range
Same family
31287Sphenoidotomy, without tissue removalSphenoidotomy without removal of tissue from the sphenoid sinus.No office rate
Used instead
31259Sinus endoscopy, total ethmoidectomy, sphenoid tissue removalIncludes total ethmoidectomy with sphenoidotomy and sphenoid tissue removal.No office rate
31257Sinus endoscopy, total ethmoidectomy and sphenoidotomyIncludes total ethmoidectomy with sphenoidotomy, but without sphenoid tissue removal.No office rate
Often billed with
31255Ethmoidectomy, total, anterior and posterior cellsMay accompany separately documented total ethmoidectomy in the same operative session.No office rate
31267Sinus endoscopy, maxillary tissue removalMay accompany separately documented maxillary sinus surgery in the same operative session.No office rate

31288 billing questions

How does this differ from 31287?

Use 31288 when tissue is removed from the sphenoid sinus during the endoscopic procedure. Code 31287 describes sphenoidotomy without tissue removal.

Can an ethmoidectomy also be reported?

A separately performed ethmoidectomy may be reported when supported by the operative documentation. When related endoscopies are performed together, CMS endoscopy-family pricing applies.

What supports reporting tissue removal?

The operative report should document tissue removal from the sphenoid sinus, along with the sinus treated and the surgical work performed. A sinus opening alone does not support the tissue-removal distinction.

How is a bilateral procedure reported?

Report modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.

Is same-day postoperative care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.

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 31288PPRRVU2026_Oct_nonQPP.csv, line 3,544 (RVU26D)

Open CMS sourceHow we calculate rates

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