FeeBase
Log inGet started
Menu

Billing code 31090: Sinus explorationMedicare rate & RVUs

Reports operative exploration of paranasal sinus disease when the documented service is surgical exploration rather than irrigation or a more specifically defined sinus procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities63 Medicare services in 2024

Medicare pays $1,011.38 for 31090 nationally in a facility.

Medicare rate · 31090

Sinus exploration

Swap in your local Medicare rate.

Work RVUs
10.89
Total RVUs
30.28
Global days
090

National rate · 2026

$1,011.38

Facility setting, before claim adjustments.

See every locality for 31090 → · 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 31090 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 31090 covers

An otolaryngologist performs this operative service to explore sinus disease that requires surgical access, such as persistent or recurrent symptoms prompting assessment of the sinus cavity. The record should identify the clinical indication, sinus or sinuses explored, operative approach, findings, and work performed. This is distinct from flushing a sinus or simply examining the nasal passages with an endoscope.

Select the code when the documented operation matches sinus exploration and a more specific procedure code does not better describe the work. The CMS 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 31090 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

31090 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$914.01
Alaska*Unavailable$1,208.05
ArizonaUnavailable$985.30
ArkansasUnavailable$901.79
AtlantaUnavailable$1,032.66
AustinUnavailable$1,040.54
BakersfieldUnavailable$1,054.60
Baltimore/Surr. CntysUnavailable$1,073.19
BeaumontUnavailable$954.10
BrazoriaUnavailable$997.25

31090 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
31090 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 31090 rate is calculated

Each of 31090’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 · 31090

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.89Practice expense 17.80Malpractice 1.59

30.2800 adjusted RVUs×$33.4009 conversion factor=$1,011.38

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

Payment rules and modifiers for 31090

31090 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 31090

Sinus exploration

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)1Not paid (statutory restriction).
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 · 31090

Sinus exploration

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

31090 without 50 · national facility

$1,011.38

Sinus exploration

31090-50 · Bilateral: 150%

$1,517.07

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

31090 compared with similar codes

Compare codes

31090 vs 31000 vs 31002 vs 31020 vs 31050: national Medicare rates

Swap in your local Medicare rate.

  • 31090
    Sinus exploration · 10.89 wRVU
    —
  • 31000
    Sinus irrigation · 1.17 wRVU
    $188.05
  • 31002
    Sinus irrigation · 1.91 wRVU
    —
  • 31020
    Maxillary sinusotomy · 2.99 wRVU
    $431.87
  • 31050
    Sphenoid sinus surgery · 5.24 wRVU
    —

How to choose

31000Sinus irrigation
31000 describes irrigation of the maxillary sinus. Choose 31090 for documented operative exploration, not lavage alone.
31002Sinus irrigation
31002 describes irrigation of the sphenoid sinus. It does not represent operative exploration.
31020Maxillary sinusotomy
31020 is directed to the maxillary sinus. Use it when the operative report supports that specific procedure rather than general sinus exploration.
31050Sphenoid sinus surgery
31050 is directed to the sphenoid sinus. The operative report should support the sinus-specific procedure to select it over 31090.

Codes related to 31090

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

Codes related to 31090
CodeHow it relatesNational office range
Used instead
31020Maxillary sinusotomyA maxillary sinus procedure for an operation specifically directed to that sinus.$380.81–$578.41
31050Sphenoid sinus surgeryA sphenoid sinus procedure when the operative work is specifically directed to that sinus.No office rate
31070Frontal sinus surgeryA frontal sinus procedure when the operative work is specifically directed to that sinus.No office rate
31000Sinus irrigationMaxillary sinus irrigation rather than operative exploration.$165.20–$253.35
31002Sinus irrigationSphenoid sinus irrigation rather than operative exploration.No office rate

31090 billing questions

How is sinus exploration different from sinus irrigation?

Exploration describes an operative service to access and assess sinus disease. Codes 31000 and 31002 describe irrigation of the maxillary and sphenoid sinuses, respectively.

When should a sinus-specific procedure code be considered instead?

Use a more specific code when the operative report documents a procedure directed to a particular sinus, such as maxillary, sphenoid, or frontal sinus surgery.

What documentation supports reporting 31090?

Document the indication, sinus or sinuses explored, approach, operative findings, and work performed so the service can be distinguished from irrigation or a specifically coded operation.

How does the 90-day global period affect postoperative reporting?

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

Can modifier 50 be used for bilateral reporting?

CMS identifies this as a bilateral procedure; reporting with modifier 50 is paid at 150%.

Can an assistant or another surgeon be paid for this operation?

Assistant-at-surgery payment is subject to a statutory restriction. 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 31090PPRRVU2026_Oct_nonQPP.csv, line 3,510 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 31090 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 31090 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →