No office rate
31255 describes total ethmoidectomy alone. Choose 31253 when the surgeon also explores the frontal sinus in the same operative service.
On this page
CMS RVU26D · Effective 2026-10-01
31253 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$420.72
Base rate per service
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.
Nasal/sinus endoscopy
About 31253: Endoscopic total ethmoidectomy with frontal exploration
Report this endoscopic sinus operation when the surgeon performs a total ethmoidectomy and explores the frontal sinus during the same procedure.
An otolaryngologist uses an endoscope through the nostril to remove ethmoid air cells as a total ethmoidectomy and access the frontal sinus. Frontal sinus tissue may also be removed when encountered. The operation is used for conditions such as chronic rhinosinusitis with obstructed frontal drainage or nasal polyps, and is typically performed in an operating room.
Select 31253 when the operative report supports both the total ethmoidectomy and frontal sinus exploration; document the work performed on each side. CMS applies endoscopy-family pricing when related endoscopies are performed together. For bilateral reporting, modifier 50 is paid at 150%. The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 31253
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.78 · 70%
- Practice expense (office) RVU2.51 · 20%
- Malpractice RVU1.29 · 10%
6.4K
Medicare services in 2024 · #1720 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.
31253 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
31276 describes frontal sinus exploration without the total ethmoidectomy. When both procedures are performed, 31253 describes their combination.
No office rate
31257 combines total ethmoidectomy with sphenoidotomy. 31253 pairs total ethmoidectomy with frontal sinus exploration instead.
$450.64
31254 represents partial ethmoidectomy. 31253 requires total ethmoidectomy and also includes frontal sinus exploration.
The same code, a different location
How does Austin compare?
31253 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 31253
Office
Unavailable
Facility
$411.73
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 31253
Office
Unavailable
Facility
$433.07
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 31253
Office
Unavailable
Facility
$455.81
No comparable office rate is available.
Miami
Florida · 31253
Office
Unavailable
Facility
$489.50
No comparable office rate is available.
Chicago
Illinois · 31253
Office
Unavailable
Facility
$478.45
No comparable office rate is available.
Manhattan
New York · 31253
Office
Unavailable
Facility
$477.78
No comparable office rate is available.
Alaska*
Alaska · 31253
Office
Unavailable
Facility
$552.92
No comparable office rate is available.
Alabama
Alabama · 31253
Office
Unavailable
Facility
$391.00
No comparable office rate is available.
Arkansas
Arkansas · 31253
Office
Unavailable
Facility
$387.47
No comparable office rate is available.
Arizona
Arizona · 31253
Office
Unavailable
Facility
$411.38
No comparable office rate is available.
Bakersfield
California · 31253
Office
Unavailable
Facility
$416.96
No comparable office rate is available.
Chico
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
El Centro
California · 31253
Office
Unavailable
Facility
$413.44
No comparable office rate is available.
Fresno
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Hanford-Corcoran
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Madera
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Merced
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Modesto
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Napa
California · 31253
Office
Unavailable
Facility
$444.12
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 31253
Office
Unavailable
Facility
$427.41
No comparable office rate is available.
Redding
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Rest Of California
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 31253
Office
Unavailable
Facility
$427.18
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 31253
Office
Unavailable
Facility
$424.41
No comparable office rate is available.
Salinas
California · 31253
Office
Unavailable
Facility
$422.61
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 31253
Office
Unavailable
Facility
$425.68
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 31253
Office
Unavailable
Facility
$459.11
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 31253
Office
Unavailable
Facility
$457.64
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 31253
Office
Unavailable
Facility
$469.51
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 31253
Office
Unavailable
Facility
$463.52
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 31253
Office
Unavailable
Facility
$416.83
No comparable office rate is available.
Santa Cruz-Watsonville
California · 31253
Office
Unavailable
Facility
$424.37
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 31253
Office
Unavailable
Facility
$422.32
No comparable office rate is available.
Santa Rosa-Petaluma
California · 31253
Office
Unavailable
Facility
$428.10
No comparable office rate is available.
Stockton
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Vallejo
California · 31253
Office
Unavailable
Facility
$442.01
No comparable office rate is available.
Visalia
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Yuba City
California · 31253
Office
Unavailable
Facility
$413.22
No comparable office rate is available.
Colorado
Colorado · 31253
Office
Unavailable
Facility
$419.63
No comparable office rate is available.
Connecticut
Connecticut · 31253
Office
Unavailable
Facility
$441.55
No comparable office rate is available.
Delaware
Delaware · 31253
Office
Unavailable
Facility
$416.29
No comparable office rate is available.
Fort Lauderdale
Florida · 31253
Office
Unavailable
Facility
$456.09
No comparable office rate is available.
Rest Of Florida
Florida · 31253
Office
Unavailable
Facility
$438.17
No comparable office rate is available.
Atlanta
Georgia · 31253
Office
Unavailable
Facility
$431.07
No comparable office rate is available.
Rest Of Georgia
Georgia · 31253
Office
Unavailable
Facility
$419.40
No comparable office rate is available.
Hawaii, Guam
Hawaii · 31253
Office
Unavailable
Facility
$413.53
No comparable office rate is available.
Iowa
Iowa · 31253
Office
Unavailable
Facility
$387.08
No comparable office rate is available.
Idaho
Idaho · 31253
Office
Unavailable
Facility
$390.77
No comparable office rate is available.
East St. Louis
Illinois · 31253
Office
Unavailable
Facility
$457.17
No comparable office rate is available.
Rest Of Illinois
Illinois · 31253
Office
Unavailable
Facility
$437.15
No comparable office rate is available.
Suburban Chicago
Illinois · 31253
Office
Unavailable
Facility
$457.76
No comparable office rate is available.
Indiana
Indiana · 31253
Office
Unavailable
Facility
$391.92
No comparable office rate is available.
Kansas
Kansas · 31253
Office
Unavailable
Facility
$390.76
No comparable office rate is available.
Kentucky
Kentucky · 31253
Office
Unavailable
Facility
$407.22
No comparable office rate is available.
New Orleans
Louisiana · 31253
Office
Unavailable
Facility
$421.10
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 31253
Office
Unavailable
Facility
$408.73
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 31253
Office
Unavailable
Facility
$443.73
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 31253
Office
Unavailable
Facility
$420.57
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 31253
Office
Unavailable
Facility
$441.21
No comparable office rate is available.
Rest Of Maryland
Maryland · 31253
Office
Unavailable
Facility
$420.59
No comparable office rate is available.
Rest Of Maine
Maine · 31253
Office
Unavailable
Facility
$397.19
No comparable office rate is available.
Southern Maine
Maine · 31253
Office
Unavailable
Facility
$403.53
No comparable office rate is available.
Detroit
Michigan · 31253
Office
Unavailable
Facility
$446.81
No comparable office rate is available.
Rest Of Michigan
Michigan · 31253
Office
Unavailable
Facility
$418.45
No comparable office rate is available.
Minnesota
Minnesota · 31253
Office
Unavailable
Facility
$392.28
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 31253
Office
Unavailable
Facility
$414.08
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 31253
Office
Unavailable
Facility
$416.25
No comparable office rate is available.
Rest Of Missouri
Missouri · 31253
Office
Unavailable
Facility
$407.49
No comparable office rate is available.
Mississippi
Mississippi · 31253
Office
Unavailable
Facility
$397.28
No comparable office rate is available.
Montana**
Montana · 31253
Office
Unavailable
Facility
$420.10
No comparable office rate is available.
North Carolina
North Carolina · 31253
Office
Unavailable
Facility
$399.01
No comparable office rate is available.
North Dakota**
North Dakota · 31253
Office
Unavailable
Facility
$394.59
No comparable office rate is available.
Nebraska
Nebraska · 31253
Office
Unavailable
Facility
$386.93
No comparable office rate is available.
New Hampshire
New Hampshire · 31253
Office
Unavailable
Facility
$418.23
No comparable office rate is available.
Northern Nj
New Jersey · 31253
Office
Unavailable
Facility
$455.00
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 31253
Office
Unavailable
Facility
$443.81
No comparable office rate is available.
New Mexico
New Mexico · 31253
Office
Unavailable
Facility
$421.89
No comparable office rate is available.
Nevada**
Nevada · 31253
Office
Unavailable
Facility
$413.07
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 31253
Office
Unavailable
Facility
$491.72
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 31253
Office
Unavailable
Facility
$450.39
No comparable office rate is available.
Queens
New York · 31253
Office
Unavailable
Facility
$473.25
No comparable office rate is available.
Rest Of New York
New York · 31253
Office
Unavailable
Facility
$403.19
No comparable office rate is available.
Ohio
Ohio · 31253
Office
Unavailable
Facility
$413.23
No comparable office rate is available.
Oklahoma
Oklahoma · 31253
Office
Unavailable
Facility
$401.60
No comparable office rate is available.
Portland
Oregon · 31253
Office
Unavailable
Facility
$423.15
No comparable office rate is available.
Rest Of Oregon
Oregon · 31253
Office
Unavailable
Facility
$407.05
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 31253
Office
Unavailable
Facility
$437.22
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 31253
Office
Unavailable
Facility
$410.94
No comparable office rate is available.
Puerto Rico
Puerto Rico · 31253
Office
Unavailable
Facility
$420.46
No comparable office rate is available.
Rhode Island
Rhode Island · 31253
Office
Unavailable
Facility
$423.87
No comparable office rate is available.
South Carolina
South Carolina · 31253
Office
Unavailable
Facility
$407.35
No comparable office rate is available.
South Dakota**
South Dakota · 31253
Office
Unavailable
Facility
$391.57
No comparable office rate is available.
Tennessee
Tennessee · 31253
Office
Unavailable
Facility
$392.60
No comparable office rate is available.
Utah
Utah · 31253
Office
Unavailable
Facility
$410.76
No comparable office rate is available.
Virginia
Virginia · 31253
Office
Unavailable
Facility
$406.09
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 31253
Office
Unavailable
Facility
$420.46
No comparable office rate is available.
Vermont
Vermont · 31253
Office
Unavailable
Facility
$398.06
No comparable office rate is available.
Rest Of Washington
Washington · 31253
Office
Unavailable
Facility
$418.14
No comparable office rate is available.
Seattle (King Cnty)
Washington · 31253
Office
Unavailable
Facility
$445.99
No comparable office rate is available.
Wisconsin
Wisconsin · 31253
Office
Unavailable
Facility
$386.85
No comparable office rate is available.
West Virginia
West Virginia · 31253
Office
Unavailable
Facility
$427.77
No comparable office rate is available.
Wyoming**
Wyoming · 31253
Office
Unavailable
Facility
$408.98
No comparable office rate is available.
See how rates vary across the country
31253 · 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 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 31253 in Austin
Multiple payment areas
- 31253 in Barton Creek
- 31253 in Bee Cave
- 31253 in Briarcliff
- 31253 in Cedar Park
Multiple payment areas
- 31253 in Creedmoor
Multiple payment areas
- 31253 in Elgin
Multiple payment areas
- 31253 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 31253 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$462.79
$420.72 × 110% = $462.79
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 31253 in Austin.
PPRRVU2026_Oct_nonQPP.csv
3,534
- Code
- 31253
- Physician work
- 8.78
- Practice expense
- 2.51
- Malpractice
- 1.29
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.78 | × 1.002 | 8.7976 |
| Practice expense | 2.51 | × 1.058 | 2.6556 |
| Malpractice | 1.29 | × 0.886 | 1.1429 |
| Total RVUs | 12.5961 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$420.72
Open 31253 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.78 | 1.002 |
| Practice expense | 2.51 | 1.058 |
| Malpractice | 1.29 | 0.886 |
(8.78 × 1.002 + 2.51 × 1.058 + 1.29 × 0.886) × $33.4009 = $420.72
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
31253 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $420.72 | RVU26D |
| 2026-07-01 | Not available in this setting | $420.72 | RVU26C |
| 2026-04-01 | Not available in this setting | $420.72 | RVU26B |
| 2026-01-01 | Not available in this setting | $420.72 | RVU26A |
| 2025-10-01 | Not available in this setting | $485.87 | RVU25D |
| 2025-07-01 | Not available in this setting | $485.87 | RVU25C |
| 2025-04-01 | Not available in this setting | $485.87 | RVU25B |
| 2025-01-01 | Not available in this setting | $485.87 | RVU25A |
31253 billing questions
When should 31253 be chosen instead of 31255?
Use 31253 when the surgeon performs a total ethmoidectomy and frontal sinus exploration. Code 31255 describes a total ethmoidectomy without the frontal sinus work.
Can 31255 or 31276 also be reported for the same operative work?
Do not separately report those codes for the total ethmoidectomy or frontal exploration already represented by 31253. CMS endoscopy-family pricing applies when related endoscopies are performed together.
How is bilateral 31253 reported?
Report modifier 50 for bilateral surgery; CMS pays the bilateral procedure at 150%. Document the work performed on both sides.
Does 31253 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can an assistant surgeon or co-surgeon be paid for 31253?
Medicare 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 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.
3,53131241,,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
3,53431253,,Nsl/sins ndsc total,A,,8.78,2.51,NA,2.51,,1.29,12.58,12.58,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53531254,,Nsl/sins ndsc w/prtl ethmdct,A,,4.16,8.31,,1.40,,0.60,13.07,6.16,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53631255,,Nsl/sins ndsc w/tot ethmdct,A,,5.61,1.75,NA,1.75,,0.82,8.18,8.18,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53731256,,Exploration maxillary sinus,A,,3.03,1.11,NA,1.11,,0.43,4.57,4.57,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858