Billing code 31233: Sinus endoscopyMedicare rate & RVUs
Reports diagnostic endoscopic inspection of the maxillary sinus through the nasal passage when the clinician evaluates disease within that sinus.
Medicare pays $272.55 for 31233 nationally in the office and $117.24 in a hospital or facility. Local office rates run $240.71–$360.32.
Medicare rate · 31233
Sinus endoscopy
- Work RVUs
- 2.13
- Total RVUs
- 8.16
- Global days
- 000
National rate · 2026
$272.55
Office setting, before claim adjustments.
See every locality for 31233 →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
What 31233 covers
An otolaryngologist or rhinologist passes an endoscope through the nasal cavity and into the maxillary sinus through its natural opening to inspect the sinus. The examination may help evaluate suspected maxillary sinus disease, such as persistent symptoms or an abnormal finding that requires direct visualization. This is distinct from an examination confined to the nasal cavity and from operative enlargement of the sinus opening or removal of tissue.
Report the service when the maxillary sinus is entered and diagnostically examined; document the approach, side or sides examined, and relevant findings. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. For bilateral reporting, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; 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 31233 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$240.71 to $360.32
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $244.28 | $108.38 |
| Alaska* | $316.06 | $150.65 |
| Arizona | $265.18 | $114.68 |
| Arkansas | $240.71 | $107.29 |
| Atlanta | $277.84 | $120.04 |
| Austin | $282.65 | $118.33 |
| Bakersfield | $288.36 | $118.13 |
| Baltimore/Surr. Cntys | $290.04 | $123.38 |
| Beaumont | $254.62 | $113.28 |
| Brazoria | $269.19 | $115.28 |
| Chicago | $286.98 | $130.89 |
| Chico | $287.48 | $117.26 |
| Colorado | $283.46 | $118.21 |
| Connecticut | $290.82 | $123.54 |
| Dallas | $271.00 | $116.31 |
| Dc + Md/Va Suburbs | $311.59 | $128.63 |
| Delaware | $269.60 | $116.15 |
| Detroit | $272.73 | $122.85 |
| East St. Louis | $267.40 | $124.51 |
| El Centro | $287.53 | $117.31 |
| Fort Lauderdale | $283.14 | $125.80 |
| Fort Worth | $269.22 | $116.08 |
| Fresno | $287.48 | $117.26 |
| Galveston | $270.06 | $115.83 |
| Hanford-Corcoran | $287.48 | $117.26 |
| Hawaii, Guam | $294.55 | $117.96 |
| Houston | $275.55 | $121.32 |
| Idaho | $251.96 | $109.07 |
| Indiana | $253.43 | $109.45 |
| Iowa | $250.24 | $108.13 |
| Kansas | $249.21 | $108.80 |
| Kentucky | $250.46 | $112.38 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $307.13 | $123.39 |
| Madera | $287.48 | $117.26 |
| Manhattan | $313.98 | $133.51 |
| Merced | $287.48 | $117.26 |
| Metropolitan Boston | $311.50 | $126.05 |
| Metropolitan Kansas City | $260.65 | $114.81 |
| Metropolitan Philadelphia | $283.61 | $121.93 |
| Metropolitan St. Louis | $263.38 | $115.53 |
| Miami | $295.72 | $134.04 |
| Minnesota | $271.05 | $111.23 |
| Mississippi | $243.33 | $109.61 |
| Modesto | $287.48 | $117.26 |
| Montana** | $272.53 | $117.22 |
| Napa | $332.96 | $128.26 |
| Nebraska | $251.58 | $108.23 |
| Nevada** | $271.07 | $115.60 |
| New Hampshire | $279.15 | $117.46 |
| New Mexico | $258.68 | $116.26 |
| New Orleans | $262.62 | $116.47 |
| North Carolina | $256.11 | $111.20 |
| North Dakota** | $266.60 | $111.29 |
| Northern Nj | $308.34 | $128.17 |
| Nyc Suburbs/Long Island | $321.86 | $137.20 |
| Ohio | $255.98 | $114.18 |
| Oklahoma | $249.84 | $111.14 |
| Oxnard-Thousand Oaks-Ventura | $305.60 | $122.02 |
| Portland | $292.37 | $119.81 |
| Poughkpsie/N Nyc Suburbs | $296.04 | $125.97 |
| Puerto Rico | $274.51 | $117.48 |
| Queens | $316.37 | $132.78 |
| Redding | $287.48 | $117.26 |
| Rest Of California | $287.48 | $117.26 |
| Rest Of Florida | $269.17 | $120.69 |
| Rest Of Georgia | $253.81 | $115.27 |
| Rest Of Illinois | $261.54 | $119.74 |
| Rest Of Louisiana | $250.12 | $112.67 |
| Rest Of Maine | $253.45 | $110.56 |
| Rest Of Maryland | $274.74 | $117.56 |
| Rest Of Massachusetts | $281.80 | $118.25 |
| Rest Of Michigan | $257.19 | $115.39 |
| Rest Of Missouri | $245.88 | $112.00 |
| Rest Of New Jersey | $293.98 | $124.37 |
| Rest Of New York | $260.01 | $112.46 |
| Rest Of Oregon | $268.81 | $114.12 |
| Rest Of Pennsylvania | $256.31 | $113.73 |
| Rest Of Texas | $261.82 | $114.43 |
| Rest Of Washington | $281.22 | $117.68 |
| Rhode Island | $279.14 | $118.70 |
| Riverside-San Bernardino-Ontario | $290.73 | $120.51 |
| Sacramento-Roseville-Folsom | $301.66 | $121.03 |
| Salinas | $300.54 | $120.53 |
| San Diego-Chula Vista-Carlsbad | $307.61 | $121.85 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $352.36 | $133.36 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $352.02 | $133.02 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $360.32 | $136.36 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $358.93 | $134.97 |
| San Luis Obispo-Paso Robles | $295.71 | $118.81 |
| Santa Cruz-Watsonville | $310.54 | $121.84 |
| Santa Maria-Santa Barbara | $301.66 | $120.57 |
| Santa Rosa-Petaluma | $313.67 | $122.95 |
| Seattle (King Cnty) | $317.72 | $127.15 |
| South Carolina | $256.50 | $112.99 |
| South Dakota** | $265.90 | $110.58 |
| Southern Maine | $267.13 | $113.22 |
| Stockton | $287.48 | $117.26 |
| Suburban Chicago | $285.95 | $126.44 |
| Tennessee | $250.50 | $109.32 |
| Utah | $260.05 | $114.05 |
| Vallejo | $332.47 | $127.77 |
| Vermont | $265.69 | $111.93 |
| Virgin Islands | $274.51 | $117.48 |
| Virginia | $266.35 | $113.68 |
| Visalia | $287.48 | $117.26 |
| West Virginia | $251.80 | $116.83 |
| Wisconsin | $257.58 | $108.79 |
| Wyoming** | $269.95 | $114.63 |
| Yuba City | $287.48 | $117.26 |
31233 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$240.71
$323.90
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $316.06 | 1 |
| AL | $244.28 | 1 |
| AR | $240.71 | 1 |
| AZ | $265.18 | 1 |
| CA | $287.48–$360.32 | 29 |
| CO | $283.46 | 1 |
| CT | $290.82 | 1 |
| DC | $311.59 | 1 |
| DE | $269.60 | 1 |
| FL | $269.17–$295.72 | 3 |
| GA | $253.81–$277.84 | 2 |
| GU | $294.55 | 1 |
| HI | $294.55 | 1 |
| IA | $250.24 | 1 |
| ID | $251.96 | 1 |
| IL | $261.54–$286.98 | 4 |
| IN | $253.43 | 1 |
| KS | $249.21 | 1 |
| KY | $250.46 | 1 |
| LA | $250.12–$262.62 | 2 |
| MA | $281.80–$311.50 | 2 |
| MD | $274.74–$311.59 | 3 |
| ME | $253.45–$267.13 | 2 |
| MI | $257.19–$272.73 | 2 |
| MN | $271.05 | 1 |
| MO | $245.88–$263.38 | 3 |
| MS | $243.33 | 1 |
| MT | $272.53 | 1 |
| NC | $256.11 | 1 |
| ND | $266.60 | 1 |
| NE | $251.58 | 1 |
| NH | $279.15 | 1 |
| NJ | $293.98–$308.34 | 2 |
| NM | $258.68 | 1 |
| NV | $271.07 | 1 |
| NY | $260.01–$321.86 | 5 |
| OH | $255.98 | 1 |
| OK | $249.84 | 1 |
| OR | $268.81–$292.37 | 2 |
| PA | $256.31–$283.61 | 2 |
| PR | $274.51 | 1 |
| RI | $279.14 | 1 |
| SC | $256.50 | 1 |
| SD | $265.90 | 1 |
| TN | $250.50 | 1 |
| TX | $254.62–$282.65 | 8 |
| UT | $260.05 | 1 |
| VA | $266.35–$311.59 | 2 |
| VI | $274.51 | 1 |
| VT | $265.69 | 1 |
| WA | $281.22–$317.72 | 2 |
| WI | $257.58 | 1 |
| WV | $251.80 | 1 |
| WY | $269.95 | 1 |
How the 31233 rate is calculated
Each of 31233’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 · 31233
RVUs × geographic indexes × conversion factor
Work2.13
2.13 RVUs× 1.000 GPCI
Practice expense5.73
5.73 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
8.1600
Conversion factor
$33.4009
Medicare rate
$272.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31233
The CMS indicators that decide how 31233 is paid alongside other services.
CMS payment indicators · 31233
Sinus endoscopy
| 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
31233 without 50 · national office
$272.55
Sinus endoscopy
31233-50 · Bilateral: 150%
$408.83
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).
31233 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31231Nasal endoscopy
- Choose 31231 for diagnostic inspection confined to the nasal cavity. Choose 31233 when the endoscope enters the maxillary sinus for diagnostic visualization.
- 31235Sinus endoscopy
- Both are diagnostic sinus endoscopy services, but 31235 targets the sphenoid sinus; 31233 targets the maxillary sinus.
- 31256Maxillary antrostomy
- 31256 is an operative maxillary sinus procedure that opens the sinus; 31233 is a diagnostic examination through the natural opening.
- 31267Sinus endoscopy
- 31267 describes operative maxillary sinus endoscopy with tissue removal. Use 31233 for diagnostic inspection without that operative tissue-removal service.
31233 billing questions
How does this differ from 31231?
31231 describes diagnostic nasal endoscopy limited to the nasal cavity. Use 31233 when the scope is advanced into and used to inspect the maxillary sinus.
How does this differ from 31235?
31235 is the diagnostic endoscopic examination of the sphenoid sinus. Code 31233 is for diagnostic examination of the maxillary sinus.
Can 31233 be reported with another endoscopy code?
Related endoscopies may be performed together, but CMS endoscopy family pricing applies. Document the distinct anatomic sites and services performed.
How is bilateral work reported?
For bilateral performance, report modifier 50; CMS pays 31233 at 150%. Document examination of both maxillary sinuses.
Can 31233 be reported for a maxillary antrostomy?
No. A diagnostic examination through the natural sinus opening is different from operative creation or enlargement of an opening, such as the service represented by 31256.
What documentation supports 31233?
Record that the endoscope entered the maxillary sinus, the side examined, and the diagnostic findings. A note describing nasal-cavity inspection alone supports a different service.
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
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