$169.32–$262.16
31231 is for diagnostic nasal endoscopy. Use 31240 when the surgeon actually resects a concha bullosa.
On this page
CMS RVU26D · Effective 2026-10-01
31240 Concha resection Medicare reimbursement rates
Reports endoscopic resection of a pneumatized middle turbinate when it obstructs nasal airflow or limits access to the middle meatus or sinuses. Compare 31240 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 31240?
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
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 31240 pays more and less
Nasal and sinus surgery
About 31240: Endoscopic concha bullosa resection
Reports endoscopic resection of a pneumatized middle turbinate when it obstructs nasal airflow or limits access to the middle meatus or sinuses.
An otolaryngologist uses a nasal endoscope to resect a concha bullosa, an air-filled expansion of the middle turbinate. This may be performed for nasal obstruction or when the enlarged turbinate narrows the middle meatus and interferes with access during sinus surgery. The service is typically performed in an operating room or ambulatory surgery setting.
The operative note should identify the affected side, the concha bullosa and its clinical effect, and the endoscopic resection performed. For bilateral work, CMS pays this procedure with modifier 50 at 150%. It 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. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 31240
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.54 · 62%
- Practice expense (office) RVU1.18 · 29%
- Malpractice RVU0.37 · 9%
4.6K
Medicare services in 2024 · #1928 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.
31240 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$236.67–$344.99
31237 concerns endoscopic biopsy or removal of nasal or sinus tissue such as a polyp; 31240 is specific to resection of a concha bullosa.
$387.69–$565.22
31254 reports partial ethmoid sinus surgery. It does not identify resection of a concha bullosa, which is reported with 31240 when performed.
See how rates vary across the country
31240 · 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 31240 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 $126.32 |
| Alaska* | Office Unavailable | Facility $176.04 |
| Arizona | Office Unavailable | Facility $133.61 |
| Arkansas | Office Unavailable | Facility $125.06 |
| Atlanta | Office Unavailable | Facility $139.98 |
| Austin | Office Unavailable | Facility $137.66 |
| Bakersfield | Office Unavailable | Facility $137.17 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $143.77 |
| Beaumont | Office Unavailable | Facility $132.19 |
| Brazoria | Office Unavailable | Facility $134.21 |
| Chicago | Office Unavailable | Facility $153.40 |
| Chico | Office Unavailable | Facility $136.10 |
| Colorado | Office Unavailable | Facility $137.44 |
| Connecticut | Office Unavailable | Facility $143.94 |
| Dallas | Office Unavailable | Facility $135.46 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $149.60 |
| Delaware | Office Unavailable | Facility $135.31 |
| Detroit | Office Unavailable | Facility $143.71 |
| East St. Louis | Office Unavailable | Facility $145.99 |
| El Centro | Office Unavailable | Facility $136.16 |
| Fort Lauderdale | Office Unavailable | Facility $147.11 |
| Fort Worth | Office Unavailable | Facility $135.23 |
| Fresno | Office Unavailable | Facility $136.10 |
| Galveston | Office Unavailable | Facility $134.89 |
| Hanford-Corcoran | Office Unavailable | Facility $136.10 |
| Hawaii, Guam | Office Unavailable | Facility $136.81 |
| Houston | Office Unavailable | Facility $141.66 |
| Idaho | Office Unavailable | Facility $126.94 |
| Indiana | Office Unavailable | Facility $127.38 |
| Iowa | Office Unavailable | Facility $125.81 |
| Kansas | Office Unavailable | Facility $126.70 |
| Kentucky | Office Unavailable | Facility $131.18 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $143.15 |
| Madera | Office Unavailable | Facility $136.10 |
| Manhattan | Office Unavailable | Facility $155.67 |
| Merced | Office Unavailable | Facility $136.10 |
| Metropolitan Boston | Office Unavailable | Facility $146.37 |
| Metropolitan Kansas City | Office Unavailable | Facility $133.92 |
| Metropolitan Philadelphia | Office Unavailable | Facility $142.14 |
| Metropolitan St. Louis | Office Unavailable | Facility $134.74 |
| Miami | Office Unavailable | Facility $157.12 |
| Minnesota | Office Unavailable | Facility $129.05 |
| Mississippi | Office Unavailable | Facility $127.91 |
| Modesto | Office Unavailable | Facility $136.10 |
| Montana** | Office Unavailable | Facility $136.58 |
| Napa | Office Unavailable | Facility $148.41 |
| Nebraska | Office Unavailable | Facility $125.89 |
| Nevada** | Office Unavailable | Facility $134.59 |
| New Hampshire | Office Unavailable | Facility $136.68 |
| New Mexico | Office Unavailable | Facility $135.82 |
| New Orleans | Office Unavailable | Facility $135.97 |
| North Carolina | Office Unavailable | Facility $129.51 |
| North Dakota** | Office Unavailable | Facility $129.27 |
| Northern Nj | Office Unavailable | Facility $149.10 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $160.08 |
| Ohio | Office Unavailable | Facility $133.28 |
| Oklahoma | Office Unavailable | Facility $129.64 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $141.50 |
| Portland | Office Unavailable | Facility $139.18 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $146.77 |
| Puerto Rico | Office Unavailable | Facility $136.86 |
| Queens | Office Unavailable | Facility $154.67 |
| Redding | Office Unavailable | Facility $136.10 |
| Rest Of California | Office Unavailable | Facility $136.10 |
| Rest Of Florida | Office Unavailable | Facility $141.09 |
| Rest Of Georgia | Office Unavailable | Facility $134.73 |
| Rest Of Illinois | Office Unavailable | Facility $140.14 |
| Rest Of Louisiana | Office Unavailable | Facility $131.56 |
| Rest Of Maine | Office Unavailable | Facility $128.79 |
| Rest Of Maryland | Office Unavailable | Facility $136.92 |
| Rest Of Massachusetts | Office Unavailable | Facility $137.55 |
| Rest Of Michigan | Office Unavailable | Facility $134.77 |
| Rest Of Missouri | Office Unavailable | Facility $130.85 |
| Rest Of New Jersey | Office Unavailable | Facility $144.83 |
| Rest Of New York | Office Unavailable | Facility $130.97 |
| Rest Of Oregon | Office Unavailable | Facility $132.78 |
| Rest Of Pennsylvania | Office Unavailable | Facility $132.70 |
| Rest Of Texas | Office Unavailable | Facility $133.40 |
| Rest Of Washington | Office Unavailable | Facility $136.85 |
| Rhode Island | Office Unavailable | Facility $138.19 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $140.10 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $140.35 |
| Salinas | Office Unavailable | Facility $139.77 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $141.22 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $154.14 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $153.72 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $157.63 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $155.91 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $137.80 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $141.13 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $139.79 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $142.41 |
| Seattle (King Cnty) | Office Unavailable | Facility $147.54 |
| South Carolina | Office Unavailable | Facility $131.76 |
| South Dakota** | Office Unavailable | Facility $128.40 |
| Southern Maine | Office Unavailable | Facility $131.69 |
| Stockton | Office Unavailable | Facility $136.10 |
| Suburban Chicago | Office Unavailable | Facility $147.81 |
| Tennessee | Office Unavailable | Facility $127.30 |
| Utah | Office Unavailable | Facility $132.98 |
| Vallejo | Office Unavailable | Facility $147.80 |
| Vermont | Office Unavailable | Facility $130.11 |
| Virgin Islands | Office Unavailable | Facility $136.86 |
| Virginia | Office Unavailable | Facility $132.31 |
| Visalia | Office Unavailable | Facility $136.10 |
| West Virginia | Office Unavailable | Facility $136.77 |
| Wisconsin | Office Unavailable | Facility $126.40 |
| Wyoming** | Office Unavailable | Facility $133.40 |
| Yuba City | Office Unavailable | Facility $136.10 |
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31240 billing questions
How is 31240 different from diagnostic nasal endoscopy?
31240 reports surgical resection of a concha bullosa, not inspection alone. Diagnostic nasal endoscopy is used when the service is an examination without this resection.
What documentation supports reporting 31240?
Document the concha bullosa, the side treated, its effect on airflow or surgical access, and the endoscopic resection performed.
Can 31240 be reported with other sinus endoscopies?
It may be performed with related sinus endoscopic procedures. CMS endoscopy-family pricing applies when related endoscopies are performed together.
How is bilateral resection reported?
Report bilateral work with modifier 50. CMS pays the bilateral procedure at 150%.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when the record documents medical necessity. 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 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.
3,52731237,,Nsl/sins ndsc surg bx polypc,A,,2.54,5.07,,1.23,,0.37,7.98,4.14,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,52831238,,Nsl/sins ndsc srg nsl hemrrg,A,,2.67,4.73,,1.26,,0.39,7.79,4.32,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,52931239,,Nsl/sinus endoscopy surg dcr,A,,8.81,5.91,NA,5.91,,0.99,15.71,15.71,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53031240,,Nsl/sns ndsc cnch bull rescj,A,,2.54,1.18,NA,1.18,,0.37,4.09,4.09,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53131241,,Nsl/sns ndsc lig sphnptn art,A,,7.80,2.23,NA,2.23,,1.14,11.17,11.17,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53231242,,Nsl/sinus ndsc rf abltj pnn,A,,2.63,68.70,,1.02,,0.39,71.72,4.04,0,000,0.00,0.00,0.00,3,2,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53331243,,Nsl/sinus ndsc cryoabltj pnn,A,,2.63,66.62,,1.02,,0.39,69.64,4.04,0,000,0.00,0.00,0.00,3,2,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00