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CMS RVU26D · Effective 2026-10-01

31296 in Delaware

Office / nonfacility

$1584.44

Base rate per service

Facility setting

$150.92

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 and sinus endoscopy

About 31296: Endoscopic frontal sinus ostium dilation

Report this service for endoscopic dilation of a frontal sinus opening, commonly using a balloon to improve drainage without removing sinus tissue.

An otolaryngologist typically performs this procedure by guiding an endoscope through the nose to the frontal sinus opening and dilating the ostium, often with a balloon catheter. It may be performed in an office or an operating room for a patient with frontal sinus drainage problems. The service is specific to the frontal sinus; dilation of a maxillary or sphenoid sinus is represented by a different site-specific code.

Report 31296 when the documented work is dilation of the frontal sinus ostium. The operative note should identify the treated sinus and side, describe the endoscopic dilation, and support the clinical need. 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. For bilateral treatment, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.

CMS billing rules for 31296

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 may be paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.02 · 6%
  • Practice expense (office) RVU44.55 · 93%
  • Malpractice RVU0.43 · 1%

5K

Medicare services in 2024 · #1873 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.

31296 compared with similar codes

Office rates for Delaware, from the same CMS release.

31295

Sinus dilation

Maxillary sinus ostium

$1,558.93

Choose 31295 for dilation of the maxillary sinus opening; 31296 is specific to the frontal sinus opening.

31297

Sinus dilation

Sphenoid ostium

$1,546.01

Choose 31297 for dilation of the sphenoid sinus opening; 31296 is specific to the frontal sinus opening.

31298

Sinus dilation

Frontal and sphenoid

$2,930.73

31298 describes dilation of both frontal and sphenoid sinus openings. Use 31296 when the documented dilation is limited to the frontal sinus.

31276

Frontal sinus endoscopy

Tissue removal when performed

No office rate

31276 describes frontal sinus exploration with tissue removal when performed. 31296 represents dilation of the frontal sinus opening, not tissue removal.

The same code, a different location

How does Delaware compare?

31296 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $1584.44

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $1874.86

    $290.42 higher than Delaware

  3. Dc + Md/Va Suburbs

    $1875.18

    $290.74 higher than Delaware

  4. Miami

    $1686.21

    $101.77 higher than Delaware

  5. Chicago

    $1629.99

    $45.55 higher than Delaware

  6. Manhattan

    $1859.17

    $274.73 higher than Delaware

  7. Alaska*

    $1743.95

    $159.51 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 31296 ranges from $1386.47 in Arkansas to $2265.38 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Alabama

    Alabama · 31296

    Office

    $1411.01

    Facility

    $141.44

    $173.43 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 31296

    Office

    $1386.47

    Facility

    $140.11

    $197.97 lower than Delaware for the office setting.

  • Arizona

    Arizona · 31296

    Office

    $1555.05

    Facility

    $149.09

    $29.39 lower than Delaware for the office setting.

  • Bakersfield

    California · 31296

    Office

    $1742.39

    Facility

    $152.17

    $157.95 higher than Delaware for the office setting.

  • Chico

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • El Centro

    California · 31296

    Office

    $1741.21

    Facility

    $150.99

    $156.77 higher than Delaware for the office setting.

  • Fresno

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Madera

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Merced

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Modesto

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Napa

    California · 31296

    Office

    $2075.72

    Facility

    $163.39

    $491.28 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 31296

    Office

    $1871.47

    Facility

    $156.47

    $287.03 higher than Delaware for the office setting.

  • Redding

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Rest Of California

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 31296

    Office

    $1745.80

    Facility

    $155.57

    $161.36 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 31296

    Office

    $1842.76

    Facility

    $155.32

    $258.32 higher than Delaware for the office setting.

  • Salinas

    California · 31296

    Office

    $1836.30

    Facility

    $154.67

    $251.86 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 31296

    Office

    $1891.34

    Facility

    $156.02

    $306.90 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 31296

    Office

    $2215.14

    Facility

    $169.32

    $630.70 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 31296

    Office

    $2214.65

    Facility

    $168.83

    $630.21 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 31296

    Office

    $2265.38

    Facility

    $173.13

    $680.94 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 31296

    Office

    $2263.38

    Facility

    $171.13

    $678.94 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 31296

    Office

    $1805.13

    Facility

    $152.51

    $220.69 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 31296

    Office

    $1918.62

    Facility

    $155.73

    $334.18 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 31296

    Office

    $1846.41

    Facility

    $154.62

    $261.97 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 31296

    Office

    $1938.87

    Facility

    $157.12

    $354.43 higher than Delaware for the office setting.

  • Stockton

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Vallejo

    California · 31296

    Office

    $2075.02

    Facility

    $162.68

    $490.58 higher than Delaware for the office setting.

  • Visalia

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Yuba City

    California · 31296

    Office

    $1741.14

    Facility

    $150.92

    $156.70 higher than Delaware for the office setting.

  • Colorado

    Colorado · 31296

    Office

    $1696.54

    Facility

    $152.75

    $112.10 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 31296

    Office

    $1722.85

    Facility

    $160.20

    $138.41 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 31296

    Office

    $1634.19

    Facility

    $164.39

    $49.75 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 31296

    Office

    $1545.00

    Facility

    $157.90

    $39.44 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 31296

    Office

    $1630.24

    Facility

    $156.09

    $45.80 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 31296

    Office

    $1445.30

    Facility

    $151.06

    $139.14 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 31296

    Office

    $1801.05

    Facility

    $151.34

    $216.61 higher than Delaware for the office setting.

  • Iowa

    Iowa · 31296

    Office

    $1468.10

    Facility

    $140.50

    $116.34 lower than Delaware for the office setting.

  • Idaho

    Idaho · 31296

    Office

    $1476.63

    Facility

    $141.77

    $107.81 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 31296

    Office

    $1498.77

    Facility

    $163.91

    $85.67 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 31296

    Office

    $1481.87

    Facility

    $157.17

    $102.57 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 31296

    Office

    $1655.21

    Facility

    $165.10

    $70.77 higher than Delaware for the office setting.

  • Indiana

    Indiana · 31296

    Office

    $1487.24

    Facility

    $142.22

    $97.20 lower than Delaware for the office setting.

  • Kansas

    Kansas · 31296

    Office

    $1453.27

    Facility

    $141.63

    $131.17 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 31296

    Office

    $1436.85

    Facility

    $146.97

    $147.59 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 31296

    Office

    $1517.40

    Facility

    $152.07

    $67.04 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 31296

    Office

    $1431.52

    Facility

    $147.44

    $152.92 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 31296

    Office

    $1894.47

    Facility

    $162.06

    $310.03 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 31296

    Office

    $1680.81

    Facility

    $152.97

    $96.37 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 31296

    Office

    $1716.89

    Facility

    $160.03

    $132.45 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 31296

    Office

    $1620.93

    Facility

    $152.58

    $36.49 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 31296

    Office

    $1478.77

    Facility

    $143.91

    $105.67 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 31296

    Office

    $1584.55

    Facility

    $146.67

    $0.11 higher than Delaware for the office setting.

  • Detroit

    Michigan · 31296

    Office

    $1561.02

    Facility

    $160.86

    $23.42 lower than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 31296

    Office

    $1475.64

    Facility

    $150.94

    $108.80 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 31296

    Office

    $1636.28

    Facility

    $143.27

    $51.84 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 31296

    Office

    $1512.14

    Facility

    $149.72

    $72.30 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 31296

    Office

    $1531.85

    Facility

    $150.56

    $52.59 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 31296

    Office

    $1397.52

    Facility

    $146.82

    $186.92 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 31296

    Office

    $1392.66

    Facility

    $143.41

    $191.78 lower than Delaware for the office setting.

  • Montana**

    Montana · 31296

    Office

    $1603.21

    Facility

    $152.28

    $18.77 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 31296

    Office

    $1498.36

    Facility

    $144.64

    $86.08 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 31296

    Office

    $1594.71

    Facility

    $143.78

    $10.27 higher than Delaware for the office setting.

  • Nebraska

    Nebraska · 31296

    Office

    $1479.73

    Facility

    $140.52

    $104.71 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 31296

    Office

    $1662.46

    Facility

    $152.03

    $78.02 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 31296

    Office

    $1848.66

    Facility

    $165.57

    $264.22 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 31296

    Office

    $1745.57

    Facility

    $161.15

    $161.13 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 31296

    Office

    $1482.63

    Facility

    $152.12

    $101.81 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 31296

    Office

    $1602.33

    Facility

    $149.95

    $17.89 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 31296

    Office

    $1903.24

    Facility

    $178.08

    $318.80 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 31296

    Office

    $1752.16

    Facility

    $163.39

    $167.72 higher than Delaware for the office setting.

  • Queens

    New York · 31296

    Office

    $1886.86

    Facility

    $171.86

    $302.42 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 31296

    Office

    $1524.58

    Facility

    $146.19

    $59.86 lower than Delaware for the office setting.

  • Ohio

    Ohio · 31296

    Office

    $1473.90

    Facility

    $149.20

    $110.54 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 31296

    Office

    $1440.82

    Facility

    $145.14

    $143.62 lower than Delaware for the office setting.

  • Portland

    Oregon · 31296

    Office

    $1766.35

    Facility

    $154.36

    $181.91 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 31296

    Office

    $1593.03

    Facility

    $147.89

    $8.59 higher than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 31296

    Office

    $1668.84

    Facility

    $158.42

    $84.40 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 31296

    Office

    $1480.44

    Facility

    $148.48

    $104.00 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 31296

    Office

    $1619.40

    Facility

    $152.50

    $34.96 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 31296

    Office

    $1652.71

    Facility

    $153.90

    $68.27 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 31296

    Office

    $1488.00

    Facility

    $147.34

    $96.44 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 31296

    Office

    $1593.71

    Facility

    $142.77

    $9.27 higher than Delaware for the office setting.

  • Tennessee

    Tennessee · 31296

    Office

    $1461.18

    Facility

    $142.28

    $123.26 lower than Delaware for the office setting.

  • Austin

    Texas · 31296

    Office

    $1688.11

    Facility

    $153.02

    $103.67 higher than Delaware for the office setting.

  • Beaumont

    Texas · 31296

    Office

    $1468.30

    Facility

    $147.95

    $116.14 lower than Delaware for the office setting.

  • Brazoria

    Texas · 31296

    Office

    $1587.50

    Facility

    $149.62

    $3.06 higher than Delaware for the office setting.

  • Dallas

    Texas · 31296

    Office

    $1596.16

    Facility

    $151.03

    $11.72 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 31296

    Office

    $1581.47

    Facility

    $150.84

    $2.97 lower than Delaware for the office setting.

  • Galveston

    Texas · 31296

    Office

    $1591.16

    Facility

    $150.39

    $6.72 higher than Delaware for the office setting.

  • Houston

    Texas · 31296

    Office

    $1599.03

    Facility

    $158.26

    $14.59 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 31296

    Office

    $1525.96

    Facility

    $149.02

    $58.48 lower than Delaware for the office setting.

  • Utah

    Utah · 31296

    Office

    $1512.50

    Facility

    $148.62

    $71.94 lower than Delaware for the office setting.

  • Virginia

    Virginia · 31296

    Office

    $1573.72

    Facility

    $147.46

    $10.72 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 31296

    Office

    $1619.40

    Facility

    $152.50

    $34.96 higher than Delaware for the office setting.

  • Vermont

    Vermont · 31296

    Office

    $1581.27

    Facility

    $144.84

    $3.17 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 31296

    Office

    $1679.99

    Facility

    $152.15

    $95.55 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 31296

    Office

    $1943.44

    Facility

    $163.14

    $359.00 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 31296

    Office

    $1530.81

    Facility

    $140.81

    $53.63 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 31296

    Office

    $1414.50

    Facility

    $153.64

    $169.94 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 31296

    Office

    $1599.51

    Facility

    $148.57

    $15.07 higher than Delaware for the office setting.

See how rates vary across the country

31296 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$1,386.47

$2,003.26

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$1,743.951
AL$1,411.011
AR$1,386.471
AZ$1,555.051
CA$1,741.14–$2,265.3829
CO$1,696.541
CT$1,722.851
DC$1,875.181
DE$1,584.441
FL$1,545.00–$1,686.213
GA$1,445.30–$1,630.242
GU$1,801.051
HI$1,801.051
IA$1,468.101
ID$1,476.631
IL$1,481.87–$1,655.214
IN$1,487.241
KS$1,453.271
KY$1,436.851
LA$1,431.52–$1,517.402
MA$1,680.81–$1,894.472
MD$1,620.93–$1,875.183
ME$1,478.77–$1,584.552
MI$1,475.64–$1,561.022
MN$1,636.281
MO$1,397.52–$1,531.853
MS$1,392.661
MT$1,603.211
NC$1,498.361
ND$1,594.711
NE$1,479.731
NH$1,662.461
NJ$1,745.57–$1,848.662
NM$1,482.631
NV$1,602.331
NY$1,524.58–$1,903.245
OH$1,473.901
OK$1,440.821
OR$1,593.03–$1,766.352
PA$1,480.44–$1,668.842
PR$1,619.401
RI$1,652.711
SC$1,488.001
SD$1,593.711
TN$1,461.181
TX$1,468.30–$1,688.118
UT$1,512.501
VA$1,573.72–$1,875.182
VI$1,619.401
VT$1,581.271
WA$1,679.99–$1,943.442
WI$1,530.811
WV$1,414.501
WY$1,599.511

Explore 31296 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 31296 in Delaware, the physician’s office rate is $1584.44 and the facility-setting rate is $150.92: a difference of $1433.52.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 31296 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$1742.88

$1584.44 × 110% = $1742.88

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.

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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 31296 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

3,551

Code
31296
Physician work
3.02
Practice expense
44.55
Malpractice
0.43

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 31296 in Delaware
ComponentRVULocality factorAdjusted
Physician work3.02× 1.0053.0351
Practice expense44.55× 0.98844.0154
Malpractice0.43× 0.8990.3866
Total RVUs47.4371
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$1584.44

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 31296 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.021.005
Practice expense44.550.988
Malpractice0.430.899

(3.02 × 1.005 + 44.55 × 0.988 + 0.43 × 0.899) × $33.4009 = $1584.44

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.021.005
Practice expense1.110.988
Malpractice0.430.899

(3.02 × 1.005 + 1.11 × 0.988 + 0.43 × 0.899) × $33.4009 = $150.92

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

31296 · Office / nonfacility

$1584.44

Effective 2026-10-01

The base rate is $48.31 higher than on 2025-10-01, moving from $1536.13 to $1584.44 (3.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $1536.13changed to$1584.44

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.10 changed to 3.02
    • Practice expense RVU 44.27 changed to 44.55
    • Malpractice RVU 0.47 changed to 0.43
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $1536.13

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$1584.44$150.92RVU26D
2026-07-01$1584.44$150.92RVU26C
2026-04-01$1584.44$150.92RVU26B
2026-01-01$1584.44$150.92RVU26A
2025-10-01$1536.13$174.65RVU25D
2025-07-01$1536.13$174.65RVU25C
2025-04-01$1536.13$174.65RVU25B
2025-01-01$1536.13$174.65RVU25A

31296 billing questions

How is 31296 different from 31295 or 31297?

31296 is for dilation of the frontal sinus ostium. Codes 31295 and 31297 describe dilation at the maxillary and sphenoid sinuses, respectively.

When is modifier 50 appropriate?

Use modifier 50 when the frontal sinus dilation is performed bilaterally. CMS identifies bilateral payment at 150%.

Can 31296 be reported with another sinus endoscopy code?

Related endoscopies performed together are subject to endoscopy family pricing. The operative documentation should establish the distinct work and sinus sites treated.

Does the code include same-day postoperative care?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid for this procedure. Co-surgeons and team surgery are not permitted under the CMS rules provided.

What should the operative note identify?

Document the frontal sinus side treated, the endoscopic dilation performed, and the clinical reason for opening the ostium. Distinguish dilation from procedures involving tissue removal.

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.

RVUs for 31296PPRRVU2026_Oct_nonQPP.csv, line 3,551 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet