Billing code 31297: Sinus dilationMedicare rate & RVUs
Endoscopic balloon dilation of the sphenoid sinus opening to improve drainage, reported when the surgeon treats the sphenoid ostium by dilation rather than sinusotomy.
Medicare pays $1,564.50 for 31297 nationally in the office and $123.58 in a hospital or facility. Local office rates run $1,350.98–$2,218.72.
Medicare rate · 31297
Sinus dilation
Swap in your local Medicare rate.
- Work RVUs
- 2.38
- Total RVUs
- 46.84
- Global days
- 000
National rate · 2026
$1,564.50
Office setting, before claim adjustments.
See every locality for 31297 → · 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 31297 covers
An otolaryngologist uses a nasal endoscope to reach and dilate the sphenoid sinus opening, commonly with a balloon catheter, to improve drainage through the natural ostium. The procedure may be performed in an office or operating room for a patient with sphenoid sinus disease or an obstructed sphenoid opening. Fluoroscopy, when used, is included in the service.
Report 31297 when the documented operative work is dilation of the sphenoid sinus ostium; distinguish it from a sphenoidotomy that opens the sinus by incision or removes tissue. The operative note should identify the treated sinus, side, endoscopic approach, and dilation performed. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. Modifier 50 identifies bilateral treatment and CMS pays the bilateral procedure at 150%. When related endoscopies are performed together, endoscopy family pricing applies. An assistant is paid only when medical necessity is documented; 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 31297 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
$1350.98 to $2218.72
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,375.16 | $114.36 |
| Alaska* | $1,694.59 | $160.02 |
| Arizona | $1,517.10 | $120.86 |
| Arkansas | $1,350.98 | $113.23 |
| Atlanta | $1,590.72 | $126.75 |
| Austin | $1,648.72 | $124.23 |
| Bakersfield | $1,702.71 | $123.47 |
| Baltimore/Surr. Cntys | $1,676.15 | $130.05 |
| Beaumont | $1,431.08 | $119.84 |
| Brazoria | $1,549.23 | $121.29 |
| Chicago | $1,587.99 | $139.87 |
| Chico | $1,701.68 | $122.43 |
| Colorado | $1,657.09 | $123.96 |
| Connecticut | $1,682.03 | $130.17 |
| Dallas | $1,557.61 | $122.46 |
| Dc + Md/Va Suburbs | $1,832.34 | $134.94 |
| Delaware | $1,546.01 | $122.38 |
| Detroit | $1,521.19 | $130.71 |
| East St. Louis | $1,458.85 | $133.21 |
| El Centro | $1,701.74 | $122.49 |
| Fort Lauderdale | $1,593.36 | $133.72 |
| Fort Worth | $1,543.04 | $122.30 |
| Fresno | $1,701.68 | $122.43 |
| Galveston | $1,552.76 | $121.93 |
| Hanford-Corcoran | $1,701.68 | $122.43 |
| Hawaii, Guam | $1,761.23 | $122.91 |
| Houston | $1,559.34 | $128.52 |
| Idaho | $1,440.32 | $114.68 |
| Indiana | $1,450.79 | $115.06 |
| Iowa | $1,432.04 | $113.61 |
| Kansas | $1,417.13 | $114.54 |
| Kentucky | $1,399.98 | $119.00 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $1,833.27 | $128.67 |
| Madera | $1,701.68 | $122.43 |
| Manhattan | $1,815.25 | $140.91 |
| Merced | $1,701.68 | $122.43 |
| Metropolitan Boston | $1,852.19 | $131.74 |
| Metropolitan Kansas City | $1,474.37 | $121.35 |
| Metropolitan Philadelphia | $1,628.64 | $128.65 |
| Metropolitan St. Louis | $1,493.82 | $122.07 |
| Miami | $1,643.28 | $143.28 |
| Minnesota | $1,598.75 | $116.05 |
| Mississippi | $1,356.62 | $115.99 |
| Modesto | $1,701.68 | $122.43 |
| Montana** | $1,564.47 | $123.56 |
| Napa | $2,032.00 | $132.87 |
| Nebraska | $1,443.60 | $113.64 |
| Nevada** | $1,563.96 | $121.61 |
| New Hampshire | $1,623.39 | $123.39 |
| New Mexico | $1,444.66 | $123.34 |
| New Orleans | $1,479.23 | $123.33 |
| North Carolina | $1,461.47 | $117.09 |
| North Dakota** | $1,557.36 | $116.44 |
| Northern Nj | $1,806.00 | $134.54 |
| Nyc Suburbs/Long Island | $1,858.28 | $145.04 |
| Ohio | $1,436.45 | $120.89 |
| Oklahoma | $1,404.21 | $117.47 |
| Oxnard-Thousand Oaks-Ventura | $1,830.27 | $127.11 |
| Portland | $1,726.19 | $125.34 |
| Poughkpsie/N Nyc Suburbs | $1,710.53 | $132.73 |
| Puerto Rico | $1,580.52 | $123.76 |
| Queens | $1,842.98 | $139.82 |
| Redding | $1,701.68 | $122.43 |
| Rest Of California | $1,701.68 | $122.43 |
| Rest Of Florida | $1,505.74 | $128.22 |
| Rest Of Georgia | $1,407.73 | $122.43 |
| Rest Of Illinois | $1,443.12 | $127.56 |
| Rest Of Louisiana | $1,394.60 | $119.39 |
| Rest Of Maine | $1,442.11 | $116.47 |
| Rest Of Maryland | $1,581.98 | $123.78 |
| Rest Of Massachusetts | $1,641.40 | $124.11 |
| Rest Of Michigan | $1,437.90 | $122.34 |
| Rest Of Missouri | $1,360.91 | $118.85 |
| Rest Of New Jersey | $1,704.36 | $130.88 |
| Rest Of New York | $1,487.28 | $118.41 |
| Rest Of Oregon | $1,555.04 | $119.88 |
| Rest Of Pennsylvania | $1,443.05 | $120.29 |
| Rest Of Texas | $1,488.21 | $120.78 |
| Rest Of Washington | $1,640.73 | $123.44 |
| Rhode Island | $1,613.32 | $124.85 |
| Riverside-San Bernardino-Ontario | $1,705.57 | $126.32 |
| Sacramento-Roseville-Folsom | $1,801.88 | $126.09 |
| Salinas | $1,795.59 | $125.57 |
| San Diego-Chula Vista-Carlsbad | $1,850.08 | $126.75 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $2,169.47 | $137.78 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $2,169.06 | $137.37 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $2,218.72 | $140.92 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $2,217.05 | $139.25 |
| San Luis Obispo-Paso Robles | $1,765.01 | $123.81 |
| Santa Cruz-Watsonville | $1,877.28 | $126.57 |
| Santa Maria-Santa Barbara | $1,805.66 | $125.55 |
| Santa Rosa-Petaluma | $1,897.14 | $127.70 |
| Seattle (King Cnty) | $1,900.64 | $132.64 |
| South Carolina | $1,450.75 | $119.34 |
| South Dakota** | $1,556.51 | $115.60 |
| Southern Maine | $1,546.80 | $118.86 |
| Stockton | $1,701.68 | $122.43 |
| Suburban Chicago | $1,614.11 | $134.29 |
| Tennessee | $1,424.89 | $115.10 |
| Utah | $1,474.89 | $120.43 |
| Vallejo | $2,031.41 | $132.28 |
| Vermont | $1,543.83 | $117.32 |
| Virgin Islands | $1,580.52 | $123.76 |
| Virginia | $1,535.92 | $119.50 |
| Visalia | $1,701.68 | $122.43 |
| West Virginia | $1,376.72 | $124.57 |
| Wisconsin | $1,494.31 | $113.92 |
| Wyoming** | $1,561.37 | $120.46 |
| Yuba City | $1,701.68 | $122.43 |
31297 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.
$1,350.98
$1,960.20
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 | $1,694.59 | 1 |
| AL | $1,375.16 | 1 |
| AR | $1,350.98 | 1 |
| AZ | $1,517.10 | 1 |
| CA | $1,701.68–$2,218.72 | 29 |
| CO | $1,657.09 | 1 |
| CT | $1,682.03 | 1 |
| DC | $1,832.34 | 1 |
| DE | $1,546.01 | 1 |
| FL | $1,505.74–$1,643.28 | 3 |
| GA | $1,407.73–$1,590.72 | 2 |
| GU | $1,761.23 | 1 |
| HI | $1,761.23 | 1 |
| IA | $1,432.04 | 1 |
| ID | $1,440.32 | 1 |
| IL | $1,443.12–$1,614.11 | 4 |
| IN | $1,450.79 | 1 |
| KS | $1,417.13 | 1 |
| KY | $1,399.98 | 1 |
| LA | $1,394.60–$1,479.23 | 2 |
| MA | $1,641.40–$1,852.19 | 2 |
| MD | $1,581.98–$1,832.34 | 3 |
| ME | $1,442.11–$1,546.80 | 2 |
| MI | $1,437.90–$1,521.19 | 2 |
| MN | $1,598.75 | 1 |
| MO | $1,360.91–$1,493.82 | 3 |
| MS | $1,356.62 | 1 |
| MT | $1,564.47 | 1 |
| NC | $1,461.47 | 1 |
| ND | $1,557.36 | 1 |
| NE | $1,443.60 | 1 |
| NH | $1,623.39 | 1 |
| NJ | $1,704.36–$1,806.00 | 2 |
| NM | $1,444.66 | 1 |
| NV | $1,563.96 | 1 |
| NY | $1,487.28–$1,858.28 | 5 |
| OH | $1,436.45 | 1 |
| OK | $1,404.21 | 1 |
| OR | $1,555.04–$1,726.19 | 2 |
| PA | $1,443.05–$1,628.64 | 2 |
| PR | $1,580.52 | 1 |
| RI | $1,613.32 | 1 |
| SC | $1,450.75 | 1 |
| SD | $1,556.51 | 1 |
| TN | $1,424.89 | 1 |
| TX | $1,431.08–$1,648.72 | 8 |
| UT | $1,474.89 | 1 |
| VA | $1,535.92–$1,832.34 | 2 |
| VI | $1,580.52 | 1 |
| VT | $1,543.83 | 1 |
| WA | $1,640.73–$1,900.64 | 2 |
| WI | $1,494.31 | 1 |
| WV | $1,376.72 | 1 |
| WY | $1,561.37 | 1 |
How the 31297 rate is calculated
Each of 31297’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 · 31297
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.38Practice expense 44.10Malpractice 0.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31297
The CMS indicators that decide how 31297 is paid alongside other services.
CMS payment indicators · 31297
Sinus dilation
| 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
31297 without 50 · national office
$1,564.50
Sinus dilation
31297-50 · Bilateral: 150%
$2,346.75
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).
31297 compared with similar codes
Compare codes
31297 vs 31298 vs 31287 vs 31288: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31298Sinus dilation
- Code 31298 covers dilation of both frontal and sphenoid sinus ostia. Use 31297 when the reported dilation is confined to the sphenoid ostium.
- 31287Sphenoidotomy
- Code 31287 is for endoscopic sphenoidotomy, while 31297 is for dilation of the sphenoid sinus opening.
- 31288Sphenoid surgery
- Code 31288 describes sphenoidotomy with tissue removal. Code 31297 describes sphenoid ostial dilation, not tissue removal.
31297 billing questions
How does 31297 differ from sphenoidotomy code 31287?
Use 31297 for dilation of the sphenoid sinus opening. Code 31287 describes endoscopic sphenoidotomy rather than ostial dilation.
Does 31297 include fluoroscopy?
Yes. Fluoroscopy, when performed as part of the sphenoid ostial dilation, is included in this service.
When is modifier 50 appropriate?
Use modifier 50 when the surgeon dilates both sphenoid sinus ostia. CMS pays the bilateral procedure at 150%.
What happens when another related sinus endoscopy is performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. The operative documentation should support each distinct sinus procedure reported.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when the documentation establishes medical necessity. Co-surgeons and team surgery are not permitted for this code.
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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