$380.81–$578.41
Choose 31030 for intranasal maxillary sinus exploration; 31020 describes maxillary sinusotomy through the Caldwell-Luc approach.
On this page
CMS RVU26D · Effective 2026-10-01
31030 Sinus exploration Medicare reimbursement rates
Intranasal exploration of the maxillary sinus is reported when an otolaryngologist surgically enters and examines that sinus rather than irrigating it. Compare 31030 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 31030?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$578.98–$852.06
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $273.08 per service.
Facility setting
$426.05–$595.34
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $169.29 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 31030 pays more and less
109 payment localities
$578.98 to $852.06
Otolaryngology surgery
About 31030: Intranasal maxillary sinus exploration
Intranasal exploration of the maxillary sinus is reported when an otolaryngologist surgically enters and examines that sinus rather than irrigating it.
An otolaryngologist uses an intranasal surgical approach to enter and examine the maxillary sinus, such as when evaluating disease or a suspected abnormality within the sinus. This is an operative exploration, not simply office-based nasal examination or lavage. The operative note should identify the maxillary sinus treated, the intranasal approach, and the findings or purpose of the exploration.
Report this code for the documented intranasal exploration; use a different code when the service is irrigation, a Caldwell-Luc approach, or endoscopic antrostomy. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 31030
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.86 · 30%
- Practice expense (office) RVU12.89 · 66%
- Malpractice RVU0.78 · 4%
273
Medicare services in 2024 · #4065 by national volume
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.
31030 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$165.20–$253.35
31000 is maxillary sinus irrigation by lavage. It does not describe operative exploration of the sinus.
No office rate
31256 describes endoscopic maxillary antrostomy. Distinguish it from 31030 by the documented procedure and approach.
See how rates vary across the country
31030 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$578.98
$768.47
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $766.47 | 1 |
| AL | $587.20 | 1 |
| AR | $578.98 | 1 |
| AZ | $635.22 | 1 |
| CA | $684.89–$852.06 | 29 |
| CO | $676.52 | 1 |
| CT | $694.86 | 1 |
| DC | $742.47 | 1 |
| DE | $645.50 | 1 |
| FL | $646.48–$709.81 | 3 |
| GA | $610.82–$665.03 | 2 |
| GU | $700.34 | 1 |
| HI | $700.34 | 1 |
| IA | $600.01 | 1 |
| ID | $604.15 | 1 |
| IL | $629.53–$689.58 | 4 |
| IN | $607.50 | 1 |
| KS | $598.07 | 1 |
| KY | $602.32 | 1 |
| LA | $601.71–$630.46 | 2 |
| MA | $672.98–$741.00 | 2 |
| MD | $657.31–$742.47 | 3 |
| ME | $608.03–$638.83 | 2 |
| MI | $618.22–$655.12 | 2 |
| MN | $646.46 | 1 |
| MO | $592.23–$631.71 | 3 |
| MS | $585.68 | 1 |
| MT | $652.27 | 1 |
| NC | $614.07 | 1 |
| ND | $636.84 | 1 |
| NE | $602.96 | 1 |
| NH | $666.72 | 1 |
| NJ | $702.29–$735.31 | 2 |
| NM | $621.82 | 1 |
| NV | $648.40 | 1 |
| NY | $623.06–$768.55 | 5 |
| OH | $615.07 | 1 |
| OK | $600.44 | 1 |
| OR | $642.86–$696.57 | 2 |
| PA | $615.58–$678.52 | 2 |
| PR | $656.66 | 1 |
| RI | $667.43 | 1 |
| SC | $615.69 | 1 |
| SD | $635.02 | 1 |
| TN | $601.08 | 1 |
| TX | $611.72–$674.71 | 8 |
| UT | $623.83 | 1 |
| VA | $637.34–$742.47 | 2 |
| VI | $656.66 | 1 |
| VT | $635.14 | 1 |
| WA | $671.46–$755.07 | 2 |
| WI | $616.21 | 1 |
| WV | $607.15 | 1 |
| WY | $645.55 | 1 |
Compare 31030 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $587.20 | Facility $431.42 |
| Alaska* | Office $766.47 | Facility $576.87 |
| Arizona | Office $635.22 | Facility $462.71 |
| Arkansas | Office $578.98 | Facility $426.05 |
| Atlanta | Office $665.03 | Facility $484.16 |
| Austin | Office $674.71 | Facility $486.36 |
| Bakersfield | Office $687.18 | Facility $492.07 |
| Baltimore/Surr. Cntys | Office $693.05 | Facility $502.03 |
| Beaumont | Office $611.72 | Facility $449.72 |
| Brazoria | Office $644.28 | Facility $467.85 |
| Chicago | Office $689.58 | Facility $510.66 |
| Chico | Office $684.89 | Facility $489.77 |
| Colorado | Office $676.52 | Facility $487.10 |
| Connecticut | Office $694.86 | Facility $503.12 |
| Dallas | Office $648.66 | Facility $471.34 |
| Dc + Md/Va Suburbs | Office $742.47 | Facility $532.75 |
| Delaware | Office $645.50 | Facility $469.61 |
| Detroit | Office $655.12 | Facility $483.33 |
| East St. Louis | Office $644.29 | Facility $480.51 |
| El Centro | Office $685.02 | Facility $489.90 |
| Fort Lauderdale | Office $678.97 | Facility $498.63 |
| Fort Worth | Office $644.69 | Facility $469.16 |
| Fresno | Office $684.89 | Facility $489.77 |
| Galveston | Office $646.39 | Facility $469.61 |
| Hanford-Corcoran | Office $684.89 | Facility $489.77 |
| Hawaii, Guam | Office $700.34 | Facility $497.92 |
| Houston | Office $660.67 | Facility $483.89 |
| Idaho | Office $604.15 | Facility $440.36 |
| Indiana | Office $607.50 | Facility $442.47 |
| Iowa | Office $600.01 | Facility $437.12 |
| Kansas | Office $598.07 | Facility $437.13 |
| Kentucky | Office $602.32 | Facility $444.05 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $730.38 | Facility $519.77 |
| Madera | Office $684.89 | Facility $489.77 |
| Manhattan | Office $749.86 | Facility $542.99 |
| Merced | Office $684.89 | Facility $489.77 |
| Metropolitan Boston | Office $741.00 | Facility $528.44 |
| Metropolitan Kansas City | Office $625.46 | Facility $458.29 |
| Metropolitan Philadelphia | Office $678.52 | Facility $493.20 |
| Metropolitan St. Louis | Office $631.71 | Facility $462.22 |
| Miami | Office $709.81 | Facility $524.48 |
| Minnesota | Office $646.46 | Facility $463.27 |
| Mississippi | Office $585.68 | Facility $432.39 |
| Modesto | Office $684.89 | Facility $489.77 |
| Montana** | Office $652.27 | Facility $474.24 |
| Napa | Office $788.74 | Facility $554.10 |
| Nebraska | Office $602.96 | Facility $438.64 |
| Nevada** | Office $648.40 | Facility $470.19 |
| New Hampshire | Office $666.72 | Facility $481.39 |
| New Mexico | Office $621.82 | Facility $458.57 |
| New Orleans | Office $630.46 | Facility $462.94 |
| North Carolina | Office $614.07 | Facility $447.97 |
| North Dakota** | Office $636.84 | Facility $458.82 |
| Northern Nj | Office $735.31 | Facility $528.80 |
| Nyc Suburbs/Long Island | Office $768.55 | Facility $556.87 |
| Ohio | Office $615.07 | Facility $452.53 |
| Oklahoma | Office $600.44 | Facility $441.46 |
| Oxnard-Thousand Oaks-Ventura | Office $726.34 | Facility $515.91 |
| Portland | Office $696.57 | Facility $498.78 |
| Poughkpsie/N Nyc Suburbs | Office $707.50 | Facility $512.56 |
| Puerto Rico | Office $656.66 | Facility $476.68 |
| Queens | Office $754.72 | Facility $544.29 |
| Redding | Office $684.89 | Facility $489.77 |
| Rest Of California | Office $684.89 | Facility $489.77 |
| Rest Of Florida | Office $646.48 | Facility $476.29 |
| Rest Of Georgia | Office $610.82 | Facility $452.02 |
| Rest Of Illinois | Office $629.53 | Facility $466.99 |
| Rest Of Louisiana | Office $601.71 | Facility $444.16 |
| Rest Of Maine | Office $608.03 | Facility $444.24 |
| Rest Of Maryland | Office $657.31 | Facility $477.14 |
| Rest Of Massachusetts | Office $672.98 | Facility $485.52 |
| Rest Of Michigan | Office $618.22 | Facility $455.69 |
| Rest Of Missouri | Office $592.23 | Facility $438.77 |
| Rest Of New Jersey | Office $702.29 | Facility $507.88 |
| Rest Of New York | Office $623.06 | Facility $453.93 |
| Rest Of Oregon | Office $642.86 | Facility $465.55 |
| Rest Of Pennsylvania | Office $615.58 | Facility $452.15 |
| Rest Of Texas | Office $627.84 | Facility $458.89 |
| Rest Of Washington | Office $671.46 | Facility $483.99 |
| Rhode Island | Office $667.43 | Facility $483.53 |
| Riverside-San Bernardino-Ontario | Office $693.34 | Facility $498.23 |
| Sacramento-Roseville-Folsom | Office $717.46 | Facility $510.41 |
| Salinas | Office $714.75 | Facility $508.42 |
| San Diego-Chula Vista-Carlsbad | Office $730.64 | Facility $517.72 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $833.34 | Facility $582.32 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $832.45 | Facility $581.44 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $852.06 | Facility $595.34 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $848.44 | Facility $591.72 |
| San Luis Obispo-Paso Robles | Office $703.40 | Facility $500.63 |
| Santa Cruz-Watsonville | Office $736.91 | Facility $520.60 |
| Santa Maria-Santa Barbara | Office $717.18 | Facility $509.60 |
| Santa Rosa-Petaluma | Office $744.27 | Facility $525.65 |
| Seattle (King Cnty) | Office $755.07 | Facility $536.63 |
| South Carolina | Office $615.69 | Facility $451.19 |
| South Dakota** | Office $635.02 | Facility $456.99 |
| Southern Maine | Office $638.83 | Facility $462.41 |
| Stockton | Office $684.89 | Facility $489.77 |
| Suburban Chicago | Office $685.43 | Facility $502.59 |
| Tennessee | Office $601.08 | Facility $439.25 |
| Utah | Office $623.83 | Facility $456.48 |
| Vallejo | Office $787.47 | Facility $552.83 |
| Vermont | Office $635.14 | Facility $458.90 |
| Virgin Islands | Office $656.66 | Facility $476.68 |
| Virginia | Office $637.34 | Facility $462.34 |
| Visalia | Office $684.89 | Facility $489.77 |
| West Virginia | Office $607.15 | Facility $452.44 |
| Wisconsin | Office $616.21 | Facility $445.66 |
| Wyoming** | Office $645.55 | Facility $467.52 |
| Yuba City | Office $684.89 | Facility $489.77 |
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31030 billing questions
How is this different from 31020?
31030 describes intranasal exploration of the maxillary sinus. Code 31020 is for a maxillary sinusotomy using the Caldwell-Luc approach.
Can maxillary sinus irrigation be reported instead?
No. Code 31000 describes maxillary sinus irrigation; use 31030 when the documented service is surgical intranasal exploration rather than lavage.
What documentation supports 31030?
Document the maxillary sinus explored, the intranasal surgical approach, and the operative findings or reason for exploration.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How are bilateral and same-session procedures handled?
Bilateral performance with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are paid at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,49431002,,Irrigation sphenoid sinus,A,,1.91,2.91,NA,2.91,,0.19,5.01,5.01,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4953100F,,Image test ref carot diam,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49631020,,Exploration maxillary sinus,A,,2.99,9.57,,6.43,,0.37,12.93,9.79,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49731030,,Exploration maxillary sinus,A,,5.86,12.89,,7.56,,0.78,19.53,14.20,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49831032,,Explore sinus remove polyps,A,,6.52,9.07,NA,9.07,,0.93,16.52,16.52,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49931040,,Exploration behind upper jaw,A,,9.53,10.65,NA,10.65,,1.43,21.61,21.61,0,090,0.10,0.76,0.14,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50031050,,Exploration sphenoid sinus,A,,5.24,8.26,NA,8.26,,0.78,14.28,14.28,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00