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Billing code 31086: Frontal sinus surgeryMedicare rate & RVUs

Frontal sinus removal surgery is reported when an operative procedure removes frontal sinus tissue rather than merely exploring or irrigating the sinus.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,056.47 for 31086 nationally in a facility.

Medicare rate · 31086

Frontal sinus surgery

Swap in your local Medicare rate.

Work RVUs
14
Total RVUs
31.63
Global days
090

National rate · 2026

$1,056.47

Facility setting, before claim adjustments.

See every locality for 31086 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 31086 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 31086 covers

Code 31086 represents an operative removal procedure involving the frontal sinus, the air cavity above the eyes that drains into the nasal passages. It is distinct from a procedure limited to examining or opening the sinus. Otolaryngologists and surgeons who manage complex frontal sinus disease may perform this work in an operating room for conditions such as persistent inflammatory disease, a mucocele, or a lesion requiring surgical removal. The operative report should identify the frontal sinus as the treated site and describe the tissue removed and the operative extent.

Report 31086 when the documented operation matches this frontal sinus removal variant, not solely because the diagnosis involves frontal sinus disease. Record the approach, anatomic extent, and concurrent procedures; use the applicable sibling code when the operative details fit another variant. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 31086 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

31086 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$961.71
Alaska*Unavailable$1,293.36
ArizonaUnavailable$1,030.48
ArkansasUnavailable$949.89
AtlantaUnavailable$1,079.96
AustinUnavailable$1,079.78
BakersfieldUnavailable$1,088.54
Baltimore/Surr. CntysUnavailable$1,118.17
BeaumontUnavailable$1,004.77
BrazoriaUnavailable$1,040.46

31086 rates by state

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

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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.

View every state and territory as a table
31086 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 31086 rate is calculated

Each of 31086’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 · 31086

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.00Practice expense 15.58Malpractice 2.05

31.6300 adjusted RVUs×$33.4009 conversion factor=$1,056.47

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 31086

31086 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 31086

Frontal sinus surgery

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.76/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 31086

Frontal sinus surgery

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

31086 without 50 · national facility

$1,056.47

Frontal sinus surgery

31086-50 · Bilateral: 150%

$1,584.71

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

31086 compared with similar codes

Compare codes

31086 vs 31070 vs 31075 vs 31084: national Medicare rates

Swap in your local Medicare rate.

  • 31086
    Frontal sinus surgery · 14 wRVU
    —
  • 31070
    Frontal sinus surgery · 4.29 wRVU
    —
  • 31075
    Frontal sinus exploration · 9.27 wRVU
    —
  • 31084
    Frontal sinus surgery · 14.58 wRVU
    —

How to choose

31070Frontal sinus surgery
31070 describes frontal sinus exploration. Use 31086 when the operation is the frontal sinus removal variant, rather than exploration alone.
31075Frontal sinus exploration
31075 is also a frontal sinus exploration code. The operative report should support removal work for 31086 rather than exploration alone.
31084Frontal sinus surgery
31084 is a sibling frontal sinus removal code. Distinguish it from 31086 by matching the documented operative technique and extent to the applicable billing code variant.

Codes related to 31086

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

Codes related to 31086
CodeHow it relatesNational office range
Same family
31080Frontal sinus surgerySibling frontal sinus removal code; choose according to the operative variant documented.No office rate
31081Frontal sinus surgerySibling frontal sinus removal code; distinguish by the specific operative variant.No office rate
31084Frontal sinus surgeryAnother frontal sinus removal code; match the documented procedure to its code variant.No office rate
31085Frontal sinus surgerySibling frontal sinus removal code; select based on the operative details.No office rate
31087Frontal sinus surgerySibling frontal sinus removal code; select the variant supported by the operative report.No office rate
Used instead
31070Frontal sinus surgeryFrontal sinus exploration is appropriate when the documented work is exploration rather than removal.No office rate
31075Frontal sinus explorationAnother frontal sinus exploration code for work limited to exploration rather than removal.No office rate

31086 billing questions

How is 31086 different from a frontal sinus exploration code?

31086 represents a removal procedure. Codes 31070 and 31075 describe frontal sinus exploration; use an exploration code when the documented work is limited to exploration rather than the removal procedure represented by 31086.

What should the operative report document?

Document the frontal sinus as the operative site, the approach and extent of the procedure, and the tissue removed. Those details help distinguish 31086 from exploration and from other frontal sinus removal variants.

How does modifier 50 affect payment?

CMS identifies this as a bilateral procedure: reporting modifier 50 results in payment at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment may be made. CMS does not permit co-surgeons or team surgery for this code.

How is 31086 affected when other procedures are performed in the same session?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures 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 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 31086PPRRVU2026_Oct_nonQPP.csv, line 3,508 (RVU26D)

Open CMS sourceHow we calculate rates

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