CPT code 31297: Sinus dilation, sphenoid ostium2026 Medicare rate & RVUs in Florida
Endoscopic balloon dilation of the sphenoid sinus opening to improve drainage, reported when the surgeon treats the sphenoid ostium by dilation rather than sinusotomy.
Medicare pays $1,505.74–$1,643.28 for 31297 in the office in Florida, from Rest of Florida to Miami, FL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 31297 covers
An otolaryngologist uses a nasal endoscope to reach and dilate the sphenoid sinus opening, commonly with a balloon catheter, to improve drainage through the natural ostium. The procedure may be performed in an office or operating room for a patient with sphenoid sinus disease or an obstructed sphenoid opening. Fluoroscopy, when used, is included in the service.
Report 31297 when the documented operative work is dilation of the sphenoid sinus ostium; distinguish it from a sphenoidotomy that opens the sinus by incision or removes tissue. The operative note should identify the treated sinus, side, endoscopic approach, and dilation performed. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. Modifier 50 identifies bilateral treatment and CMS pays the bilateral procedure at 150%. When related endoscopies are performed together, endoscopy family pricing applies. An assistant is paid only when medical necessity is documented; 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 31297 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$1505.74 to $1643.28
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | $1,593.36 | $133.72 |
| Miami, FL | $1,643.28 | $143.28 |
| Rest of Florida | $1,505.74 | $128.22 |
How the 31297 rate is calculated
Each of 31297’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 · 31297
RVUs × geographic indexes × conversion factor
Work2.38
2.38 RVUs× 1.000 GPCI
Practice expense44.10
44.10 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
46.8400
Conversion factor
$33.4009
Medicare rate
$1,564.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31297
The CMS indicators that decide how 31297 is paid alongside other services.
CMS payment indicators · 31297
Sinus dilation, sphenoid ostium
| 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
31297 without 50 · national office
$1,564.50
Sinus dilation, sphenoid ostium
31297-50 · Bilateral: 150%
$2,346.75
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).
31297 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31298Sinus dilationFrontal and sphenoid
- Code 31298 covers dilation of both frontal and sphenoid sinus ostia. Use 31297 when the reported dilation is confined to the sphenoid ostium.
- 31287SphenoidotomyWithout tissue removal
- Code 31287 is for endoscopic sphenoidotomy, while 31297 is for dilation of the sphenoid sinus opening.
- 31288Sphenoid surgerySphenoid tissue removal
- Code 31288 describes sphenoidotomy with tissue removal. Code 31297 describes sphenoid ostial dilation, not tissue removal.
31297 billing questions
How does 31297 differ from sphenoidotomy code 31287?
Use 31297 for dilation of the sphenoid sinus opening. Code 31287 describes endoscopic sphenoidotomy rather than ostial dilation.
Does 31297 include fluoroscopy?
Yes. Fluoroscopy, when performed as part of the sphenoid ostial dilation, is included in this service.
When is modifier 50 appropriate?
Use modifier 50 when the surgeon dilates both sphenoid sinus ostia. CMS pays the bilateral procedure at 150%.
What happens when another related sinus endoscopy is performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. The operative documentation should support each distinct sinus procedure reported.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when the documentation establishes medical necessity. Co-surgeons and team surgery are not permitted 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
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