No office rate
Both are intranasal ethmoidectomies; 31200 is limited to the anterior ethmoid, while 31201 represents total ethmoid removal.
On this page
CMS RVU26D · Effective 2026-10-01
31200 Ethmoidectomy Medicare reimbursement rates
Reports surgical removal of anterior ethmoid air cells through an intranasal approach, rather than endoscopic ethmoidectomy or a more extensive ethmoid removal. Compare 31200 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 31200?
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
No supported rate
Facility setting
$520.47–$773.82
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $253.35 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 31200 pays more and less
Sinus surgery
About 31200: Anterior intranasal ethmoidectomy
Reports surgical removal of anterior ethmoid air cells through an intranasal approach, rather than endoscopic ethmoidectomy or a more extensive ethmoid removal.
An otolaryngologist removes diseased tissue and air cells from the anterior ethmoid sinus through the nasal passage. The operation may be performed for ethmoid sinus disease when surgical treatment is needed; the code identifies the anterior portion and intranasal approach. It is distinct from endoscopic ethmoidectomy codes and from removal of the entire ethmoid sinus.
Report this code when the operative record supports an anterior intranasal ethmoidectomy, documenting the approach, extent, and side treated. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures, 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 at 50%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 31200
- 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 RVU5.01 · 29%
- Practice expense (office) RVU12.05 · 69%
- Malpractice RVU0.43 · 2%
876
Medicare services in 2024 · #3064 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.
31200 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
31205 describes total ethmoid removal through an extranasal approach. Choose 31200 for the anterior intranasal operation.
$387.69–$565.22
31254 is for partial ethmoidectomy performed endoscopically. The approach, not just the limited extent, distinguishes it from 31200.
No office rate
31255 reports total endoscopic ethmoidectomy; 31200 reports anterior ethmoid removal through an intranasal approach.
See how rates vary across the country
31200 · 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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 31200 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 Unavailable | Facility $527.64 |
| Alaska* | Office Unavailable | Facility $687.56 |
| Arizona | Office Unavailable | Facility $569.64 |
| Arkansas | Office Unavailable | Facility $520.47 |
| Atlanta | Office Unavailable | Facility $594.01 |
| Austin | Office Unavailable | Facility $606.22 |
| Bakersfield | Office Unavailable | Facility $620.38 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $619.64 |
| Beaumont | Office Unavailable | Facility $546.94 |
| Brazoria | Office Unavailable | Facility $578.74 |
| Chicago | Office Unavailable | Facility $605.96 |
| Chico | Office Unavailable | Facility $619.00 |
| Colorado | Office Unavailable | Facility $608.80 |
| Connecticut | Office Unavailable | Facility $621.54 |
| Dallas | Office Unavailable | Facility $582.04 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $666.48 |
| Delaware | Office Unavailable | Facility $578.74 |
| Detroit | Office Unavailable | Facility $579.95 |
| East St. Louis | Office Unavailable | Facility $566.55 |
| El Centro | Office Unavailable | Facility $619.07 |
| Fort Lauderdale | Office Unavailable | Facility $601.02 |
| Fort Worth | Office Unavailable | Facility $578.20 |
| Fresno | Office Unavailable | Facility $619.00 |
| Galveston | Office Unavailable | Facility $580.23 |
| Hanford-Corcoran | Office Unavailable | Facility $619.00 |
| Hawaii, Guam | Office Unavailable | Facility $633.28 |
| Houston | Office Unavailable | Facility $588.10 |
| Idaho | Office Unavailable | Facility $544.41 |
| Indiana | Office Unavailable | Facility $547.42 |
| Iowa | Office Unavailable | Facility $541.31 |
| Kansas | Office Unavailable | Facility $538.42 |
| Kentucky | Office Unavailable | Facility $538.29 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $659.87 |
| Madera | Office Unavailable | Facility $619.00 |
| Manhattan | Office Unavailable | Facility $668.51 |
| Merced | Office Unavailable | Facility $619.00 |
| Metropolitan Boston | Office Unavailable | Facility $667.54 |
| Metropolitan Kansas City | Office Unavailable | Facility $559.30 |
| Metropolitan Philadelphia | Office Unavailable | Facility $606.47 |
| Metropolitan St. Louis | Office Unavailable | Facility $564.89 |
| Miami | Office Unavailable | Facility $622.64 |
| Minnesota | Office Unavailable | Facility $585.74 |
| Mississippi | Office Unavailable | Facility $524.49 |
| Modesto | Office Unavailable | Facility $619.00 |
| Montana** | Office Unavailable | Facility $584.15 |
| Napa | Office Unavailable | Facility $715.65 |
| Nebraska | Office Unavailable | Facility $544.26 |
| Nevada** | Office Unavailable | Facility $582.19 |
| New Hampshire | Office Unavailable | Facility $598.89 |
| New Mexico | Office Unavailable | Facility $553.66 |
| New Orleans | Office Unavailable | Facility $562.39 |
| North Carolina | Office Unavailable | Facility $552.03 |
| North Dakota** | Office Unavailable | Facility $575.65 |
| Northern Nj | Office Unavailable | Facility $660.10 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $683.27 |
| Ohio | Office Unavailable | Facility $549.28 |
| Oklahoma | Office Unavailable | Facility $537.91 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $656.70 |
| Portland | Office Unavailable | Facility $627.86 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $632.96 |
| Puerto Rico | Office Unavailable | Facility $588.39 |
| Queens | Office Unavailable | Facility $674.49 |
| Redding | Office Unavailable | Facility $619.00 |
| Rest Of California | Office Unavailable | Facility $619.00 |
| Rest Of Florida | Office Unavailable | Facility $573.70 |
| Rest Of Georgia | Office Unavailable | Facility $543.47 |
| Rest Of Illinois | Office Unavailable | Facility $557.25 |
| Rest Of Louisiana | Office Unavailable | Facility $537.29 |
| Rest Of Maine | Office Unavailable | Facility $546.55 |
| Rest Of Maryland | Office Unavailable | Facility $589.51 |
| Rest Of Massachusetts | Office Unavailable | Facility $605.28 |
| Rest Of Michigan | Office Unavailable | Facility $551.02 |
| Rest Of Missouri | Office Unavailable | Facility $528.27 |
| Rest Of New Jersey | Office Unavailable | Facility $629.30 |
| Rest Of New York | Office Unavailable | Facility $559.79 |
| Rest Of Oregon | Office Unavailable | Facility $578.31 |
| Rest Of Pennsylvania | Office Unavailable | Facility $550.39 |
| Rest Of Texas | Office Unavailable | Facility $562.26 |
| Rest Of Washington | Office Unavailable | Facility $604.26 |
| Rhode Island | Office Unavailable | Facility $599.09 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $623.72 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $649.15 |
| Salinas | Office Unavailable | Facility $646.70 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $661.51 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $757.33 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $756.84 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $773.82 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $771.82 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $636.31 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $667.57 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $649.01 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $674.30 |
| Seattle (King Cnty) | Office Unavailable | Facility $681.28 |
| South Carolina | Office Unavailable | Facility $551.44 |
| South Dakota** | Office Unavailable | Facility $574.65 |
| Southern Maine | Office Unavailable | Facility $575.26 |
| Stockton | Office Unavailable | Facility $619.00 |
| Suburban Chicago | Office Unavailable | Facility $607.31 |
| Tennessee | Office Unavailable | Facility $540.91 |
| Utah | Office Unavailable | Facility $558.57 |
| Vallejo | Office Unavailable | Facility $714.94 |
| Vermont | Office Unavailable | Facility $573.06 |
| Virgin Islands | Office Unavailable | Facility $588.39 |
| Virginia | Office Unavailable | Facility $573.12 |
| Visalia | Office Unavailable | Facility $619.00 |
| West Virginia | Office Unavailable | Facility $537.65 |
| Wisconsin | Office Unavailable | Facility $557.34 |
| Wyoming** | Office Unavailable | Facility $580.45 |
| Yuba City | Office Unavailable | Facility $619.00 |
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31200 billing questions
How does this differ from 31201?
31200 describes removal of the anterior ethmoid portion. 31201 is the related intranasal code for total ethmoid removal, so the documented extent determines the choice.
When would an endoscopic ethmoidectomy code be more appropriate?
Use an endoscopic ethmoidectomy code when the surgeon performs the ethmoid work endoscopically. Codes 31254 and 31255 distinguish partial from total endoscopic ethmoidectomy.
What documentation supports 31200?
The operative report should identify the intranasal approach, the anterior ethmoid work performed, and the side treated. Record the extent clearly enough to distinguish anterior removal from total ethmoidectomy.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
3,5153117F,,Hf assessment tool completed,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
3,5163118F,,Ny heart assoc class docd,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
3,5173119F,,No eval activity clin symp,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
3,51831200,,Removal of ethmoid sinus,A,,5.01,12.05,NA,12.05,,0.43,17.49,17.49,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,51931201,,Removal of ethmoid sinus,A,,8.39,11.62,NA,11.62,,1.23,21.24,21.24,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,52031205,,Removal of ethmoid sinus,A,,10.32,13.94,NA,13.94,,0.92,25.18,25.18,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,5213120F,,12-lead ecg performed,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