Billing code 31242: Nerve ablationMedicare rate & RVUs
Endoscopic radiofrequency ablation of the posterior nasal nerve is reported to treat chronic rhinitis when nerve-directed treatment is performed.
Medicare pays $2,395.51 for 31242 nationally in the office and $134.94 in a hospital or facility. Local office rates run $2,065.65–$3,413.36.
Medicare rate · 31242
Nerve ablation
Swap in your local Medicare rate.
- Work RVUs
- 2.63
- Total RVUs
- 71.72
- Global days
- 000
National rate · 2026
$2,395.51
Office setting, before claim adjustments.
See every locality for 31242 → · 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 31242 covers
An otolaryngologist uses a nasal endoscope to guide radiofrequency energy to the posterior nasal nerve region. The procedure is used for chronic rhinitis, including persistent nasal drainage or congestion, when the treatment plan calls for nerve ablation. It is commonly performed in an office or ambulatory setting, depending on the clinician, equipment, and patient circumstances. This is an operative endoscopic treatment, not a diagnostic nasal examination or a procedure to remove a polyp.
Report the code for the radiofrequency ablation service; document the rhinitis indication, endoscopic approach, treatment performed, and energy modality. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. The code is priced as bilateral, and modifier 50 does not increase payment. When related endoscopies are performed in the same session, endoscopy-family pricing applies. CMS does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing 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 31242 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
$2065.65 to $3413.36
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $2,103.03 | $125.03 |
| Alaska* | $2,582.74 | $175.23 |
| Arizona | $2,322.50 | $132.01 |
| Arkansas | $2,065.65 | $123.82 |
| Atlanta | $2,435.11 | $138.37 |
| Austin | $2,527.29 | $135.61 |
| Bakersfield | $2,612.37 | $134.79 |
| Baltimore/Surr. Cntys | $2,567.51 | $141.92 |
| Beaumont | $2,188.07 | $130.95 |
| Brazoria | $2,372.70 | $132.47 |
| Chicago | $2,424.47 | $152.59 |
| Chico | $2,611.25 | $133.66 |
| Colorado | $2,540.57 | $135.32 |
| Connecticut | $2,576.69 | $142.06 |
| Dallas | $2,385.27 | $133.74 |
| Dc + Md/Va Suburbs | $2,810.17 | $147.22 |
| Delaware | $2,367.10 | $133.65 |
| Detroit | $2,324.14 | $142.68 |
| East St. Louis | $2,225.15 | $145.42 |
| El Centro | $2,611.31 | $133.72 |
| Fort Lauderdale | $2,435.87 | $145.91 |
| Fort Worth | $2,362.50 | $133.57 |
| Fresno | $2,611.25 | $133.66 |
| Galveston | $2,377.91 | $133.16 |
| Hanford-Corcoran | $2,611.25 | $133.66 |
| Hawaii, Guam | $2,704.39 | $134.12 |
| Houston | $2,385.05 | $140.30 |
| Idaho | $2,205.08 | $125.35 |
| Indiana | $2,221.31 | $125.76 |
| Iowa | $2,192.61 | $124.19 |
| Kansas | $2,168.77 | $125.21 |
| Kentucky | $2,139.70 | $130.05 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $2,814.66 | $140.40 |
| Madera | $2,611.25 | $133.66 |
| Manhattan | $2,780.50 | $153.71 |
| Merced | $2,611.25 | $133.66 |
| Metropolitan Boston | $2,842.84 | $143.72 |
| Metropolitan Kansas City | $2,255.24 | $132.56 |
| Metropolitan Philadelphia | $2,493.69 | $140.43 |
| Metropolitan St. Louis | $2,285.40 | $133.33 |
| Miami | $2,509.51 | $156.25 |
| Minnesota | $2,452.89 | $126.76 |
| Mississippi | $2,073.16 | $126.80 |
| Modesto | $2,611.25 | $133.66 |
| Montana** | $2,395.49 | $134.91 |
| Napa | $3,124.33 | $144.90 |
| Nebraska | $2,210.72 | $124.21 |
| Nevada** | $2,395.63 | $132.80 |
| New Hampshire | $2,487.96 | $134.71 |
| New Mexico | $2,207.68 | $134.73 |
| New Orleans | $2,261.90 | $134.70 |
| North Carolina | $2,237.07 | $127.95 |
| North Dakota** | $2,387.77 | $127.20 |
| Northern Nj | $2,769.08 | $146.81 |
| Nyc Suburbs/Long Island | $2,845.99 | $158.16 |
| Ohio | $2,195.98 | $132.08 |
| Oklahoma | $2,147.08 | $128.39 |
| Oxnard-Thousand Oaks-Ventura | $2,810.69 | $138.69 |
| Portland | $2,648.29 | $136.79 |
| Poughkpsie/N Nyc Suburbs | $2,620.19 | $144.86 |
| Puerto Rico | $2,420.56 | $135.12 |
| Queens | $2,824.52 | $152.52 |
| Redding | $2,611.25 | $133.66 |
| Rest Of California | $2,611.25 | $133.66 |
| Rest Of Florida | $2,301.10 | $139.99 |
| Rest Of Georgia | $2,150.19 | $133.76 |
| Rest Of Illinois | $2,203.21 | $139.31 |
| Rest Of Louisiana | $2,131.08 | $130.47 |
| Rest Of Maine | $2,207.02 | $127.29 |
| Rest Of Maryland | $2,422.86 | $135.16 |
| Rest Of Massachusetts | $2,515.89 | $135.51 |
| Rest Of Michigan | $2,197.56 | $133.66 |
| Rest Of Missouri | $2,078.51 | $129.90 |
| Rest Of New Jersey | $2,611.40 | $142.85 |
| Rest Of New York | $2,276.91 | $129.37 |
| Rest Of Oregon | $2,382.47 | $130.93 |
| Rest Of Pennsylvania | $2,206.64 | $131.43 |
| Rest Of Texas | $2,277.22 | $131.94 |
| Rest Of Washington | $2,515.16 | $134.77 |
| Rhode Island | $2,471.50 | $136.33 |
| Riverside-San Bernardino-Ontario | $2,615.46 | $137.88 |
| Sacramento-Roseville-Folsom | $2,766.66 | $137.61 |
| Salinas | $2,757.04 | $137.04 |
| San Diego-Chula Vista-Carlsbad | $2,841.93 | $138.29 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $3,337.61 | $150.21 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $3,337.17 | $149.76 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $3,413.36 | $153.62 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $3,411.55 | $151.81 |
| San Luis Obispo-Paso Robles | $2,709.92 | $135.12 |
| Santa Cruz-Watsonville | $2,884.66 | $138.06 |
| Santa Maria-Santa Barbara | $2,772.84 | $137.01 |
| Santa Rosa-Petaluma | $2,915.28 | $139.30 |
| Seattle (King Cnty) | $2,918.40 | $144.68 |
| South Carolina | $2,219.17 | $130.40 |
| South Dakota** | $2,386.86 | $126.29 |
| Southern Maine | $2,370.05 | $129.83 |
| Stockton | $2,611.25 | $133.66 |
| Suburban Chicago | $2,468.14 | $146.53 |
| Tennessee | $2,180.67 | $125.81 |
| Utah | $2,256.51 | $131.57 |
| Vallejo | $3,123.70 | $144.26 |
| Vermont | $2,366.13 | $128.16 |
| Virgin Islands | $2,420.56 | $135.12 |
| Virginia | $2,352.67 | $130.53 |
| Visalia | $2,611.25 | $133.66 |
| West Virginia | $2,100.53 | $136.09 |
| Wisconsin | $2,290.12 | $124.49 |
| Wyoming** | $2,392.13 | $131.55 |
| Yuba City | $2,611.25 | $133.66 |
31242 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$2,065.65
$3,012.31
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 | $2,582.74 | 1 |
| AL | $2,103.03 | 1 |
| AR | $2,065.65 | 1 |
| AZ | $2,322.50 | 1 |
| CA | $2,611.25–$3,413.36 | 29 |
| CO | $2,540.57 | 1 |
| CT | $2,576.69 | 1 |
| DC | $2,810.17 | 1 |
| DE | $2,367.10 | 1 |
| FL | $2,301.10–$2,509.51 | 3 |
| GA | $2,150.19–$2,435.11 | 2 |
| GU | $2,704.39 | 1 |
| HI | $2,704.39 | 1 |
| IA | $2,192.61 | 1 |
| ID | $2,205.08 | 1 |
| IL | $2,203.21–$2,468.14 | 4 |
| IN | $2,221.31 | 1 |
| KS | $2,168.77 | 1 |
| KY | $2,139.70 | 1 |
| LA | $2,131.08–$2,261.90 | 2 |
| MA | $2,515.89–$2,842.84 | 2 |
| MD | $2,422.86–$2,810.17 | 3 |
| ME | $2,207.02–$2,370.05 | 2 |
| MI | $2,197.56–$2,324.14 | 2 |
| MN | $2,452.89 | 1 |
| MO | $2,078.51–$2,285.40 | 3 |
| MS | $2,073.16 | 1 |
| MT | $2,395.49 | 1 |
| NC | $2,237.07 | 1 |
| ND | $2,387.77 | 1 |
| NE | $2,210.72 | 1 |
| NH | $2,487.96 | 1 |
| NJ | $2,611.40–$2,769.08 | 2 |
| NM | $2,207.68 | 1 |
| NV | $2,395.63 | 1 |
| NY | $2,276.91–$2,845.99 | 5 |
| OH | $2,195.98 | 1 |
| OK | $2,147.08 | 1 |
| OR | $2,382.47–$2,648.29 | 2 |
| PA | $2,206.64–$2,493.69 | 2 |
| PR | $2,420.56 | 1 |
| RI | $2,471.50 | 1 |
| SC | $2,219.17 | 1 |
| SD | $2,386.86 | 1 |
| TN | $2,180.67 | 1 |
| TX | $2,188.07–$2,527.29 | 8 |
| UT | $2,256.51 | 1 |
| VA | $2,352.67–$2,810.17 | 2 |
| VI | $2,420.56 | 1 |
| VT | $2,366.13 | 1 |
| WA | $2,515.16–$2,918.40 | 2 |
| WI | $2,290.12 | 1 |
| WV | $2,100.53 | 1 |
| WY | $2,392.13 | 1 |
How the 31242 rate is calculated
Each of 31242’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 · 31242
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.63Practice expense 68.70Malpractice 0.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31242
The CMS indicators that decide how 31242 is paid alongside other services.
CMS payment indicators · 31242
Nerve ablation
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 51 · payment effect
With and without the modifier
31242 without 51 · national office
$2,395.51
Nerve ablation
31242-51 · Second procedure: 50%
$1,197.76
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
31242 compared with similar codes
Compare codes
31242 vs 31243 vs 31231 vs 31237: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31243Nasal nerve ablation
- Both codes address endoscopic posterior nasal nerve ablation; choose 31242 for radiofrequency and 31243 for cryoablation.
- 31231Nasal endoscopy
- 31231 describes diagnostic nasal endoscopy. This code describes therapeutic radiofrequency ablation of the posterior nasal nerve.
- 31237Nasal endoscopy
- 31237 covers endoscopic biopsy or polyp removal. Use this code when the operative target is posterior nasal nerve ablation instead.
31242 billing questions
When should this code be chosen over 31243?
Use this code when posterior nasal nerve ablation is performed with radiofrequency energy. Code 31243 describes the cryoablation method.
Does modifier 50 increase payment?
No. CMS prices this code as bilateral, so modifier 50 does not increase payment.
Can a diagnostic nasal endoscopy also be reported?
This code represents endoscopic surgical treatment, not a diagnostic examination. The operative endoscopy used to perform the ablation is part of the service.
What documentation supports reporting the code?
Document the chronic rhinitis indication, endoscopic approach, posterior nasal nerve treatment, and use of radiofrequency energy.
How does CMS price it with another related endoscopy?
Endoscopy-family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included under the 0-day global period.
May 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.
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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