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Billing code 31287: SphenoidotomyMedicare rate & RVUs

Reports endoscopic opening of the sphenoid sinus to improve drainage, without removing tissue from that sinus.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.1K Medicare services in 2024

Medicare pays $170.34 for 31287 nationally in a facility.

Medicare rate · 31287

Sphenoidotomy

Swap in your local Medicare rate.

Work RVUs
3.41
Total RVUs
5.10
Global days
000

National rate · 2026

$170.34

Facility setting, before claim adjustments.

See every locality for 31287 → · 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 31287 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 31287 covers

An otolaryngologist typically performs this procedure through the nasal passages, using an endoscope to open the sphenoid sinus. It may be performed for sphenoid sinus disease when the surgeon needs to establish or improve drainage but does not remove tissue from the sinus. The operative report should identify the sphenoid sinus treated and describe the surgical opening; tissue removal from that sinus points to a different code.

Report the service for the sphenoidotomy itself, not as a substitute for a more extensive procedure that includes ethmoid surgery or sphenoid tissue removal. CMS assigns 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 work, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented 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 31287 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

31287 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$158.33
Alaska*Unavailable$222.72
ArizonaUnavailable$166.78
ArkansasUnavailable$156.87
AtlantaUnavailable$174.56
AustinUnavailable$171.09
BakersfieldUnavailable$170.12
Baltimore/Surr. CntysUnavailable$178.92
BeaumontUnavailable$165.57
BrazoriaUnavailable$167.36

31287 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.

View every state and territory as a table
31287 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 31287 rate is calculated

Each of 31287’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 · 31287

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.41Practice expense 1.21Malpractice 0.48

5.1000 adjusted RVUs×$33.4009 conversion factor=$170.34

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

Payment rules and modifiers for 31287

The CMS indicators that decide how 31287 is paid alongside other services.

CMS payment indicators · 31287

Sphenoidotomy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

31287 without 50 · national facility

$170.34

Sphenoidotomy

31287-50 · Bilateral: 150%

$255.51

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

31287 compared with similar codes

Compare codes

31287 vs 31288 vs 31257 vs 31297: national Medicare rates

Swap in your local Medicare rate.

  • 31287
    Sphenoidotomy · 3.41 wRVU
    —
  • 31288
    Sphenoid surgery · 4 wRVU
    —
  • 31257
    Sinus endoscopy · 7.8 wRVU
    —
  • 31297
    Sinus dilation · 2.38 wRVU
    $1,564.50

How to choose

31288Sphenoid surgery
31287 is for sphenoidotomy without tissue removal from that sinus; 31288 includes sphenoid tissue removal.
31257Sinus endoscopy
31257 includes total ethmoid surgery with sphenoidotomy, while 31287 describes sphenoidotomy alone.
31297Sinus dilation
31297 describes balloon dilation of the sphenoid sinus ostium; 31287 is a surgical sphenoidotomy.

Codes related to 31287

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

Codes related to 31287
CodeHow it relatesNational office range
Same family
31288Sphenoid surgerySphenoidotomy with tissue removal from the sphenoid sinus.No office rate
31257Sinus endoscopyCombines sphenoidotomy with total ethmoid surgery.No office rate
31259Sinus endoscopyCombines total ethmoid surgery and sphenoidotomy with sphenoid tissue removal.No office rate
Used instead
31297Sinus dilationUses balloon dilation for sphenoid sinus ostial dilation rather than surgical sphenoidotomy.$1,350.98–$2,218.72

31287 billing questions

When should 31287 be chosen over 31288?

Use 31287 when the sphenoid sinus is surgically opened without tissue removal from that sinus. When tissue is removed from the sphenoid sinus, consider 31288 instead.

How does 31287 differ from 31257?

31287 covers sphenoidotomy alone. 31257 includes total ethmoid surgery along with sphenoidotomy.

Can modifier 50 be reported for bilateral sphenoidotomy?

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

Is same-day postoperative care included?

Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be billed?

Assistant-at-surgery payment is allowed only with documentation of 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 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 31287PPRRVU2026_Oct_nonQPP.csv, line 3,543 (RVU26D)

Open CMS sourceHow we calculate rates

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