No office rate
Both codes report endoscopic CSF leak repair, but the repair site determines the choice: ethmoid region for 31290 and sphenoid region for 31291.
On this page
CMS RVU26D · Effective 2026-10-01
31290 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$986.62
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 surgery
About 31290: Endoscopic ethmoid CSF leak repair
Reports endoscopic repair of a cerebrospinal fluid leak at the ethmoid region, such as a skull-base defect causing clear nasal drainage.
An otolaryngologist, often a rhinologist, uses a nasal endoscope to locate and close a cerebrospinal fluid leak involving the ethmoid region of the skull base. The repair may use graft material or a vascularized flap to seal the defect. Typical situations include persistent clear nasal drainage from a spontaneous, traumatic, or prior surgical skull-base opening. The procedure is generally performed in an operating room, commonly in a hospital outpatient or inpatient setting.
Report 31290 when the operative documentation identifies repair of a CSF leak in the ethmoid region; a sinus exploration or ethmoidectomy alone is not this service. The operative report should support the leak site and describe the endoscopic repair. CMS assigns a 10-day global period, which includes related postoperative visits during that period. When related nasal or sinus endoscopies are performed together, endoscopy-family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 31290
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.14 · 61%
- Practice expense (office) RVU8.73 · 29%
- Malpractice RVU2.84 · 10%
95
Medicare services in 2024 · #4922 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.
31290 compared with similar codes
Office rates for Merced, from the same CMS release.
$456.26
31254 reports partial ethmoidectomy, not repair of a CSF leak. Use 31290 when the documented service is endoscopic closure of an ethmoid-region leak.
No office rate
31255 reports total ethmoidectomy. It is not a substitute for 31290 when the procedure repairs an ethmoid-region CSF leak.
No office rate
31288 involves sphenoidotomy with tissue removal. It does not describe repair of a CSF leak in the ethmoid region.
The same code, a different location
How does Merced compare?
31290 across payment areas
Same release and payment basis · bars start at $0
Merced · 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.
No comparable rate is available in this setting.
Other payment areas listed in California 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
Madera
California · 31290
Office
Unavailable
Facility
$986.62
No comparable office rate is available.
Modesto
California · 31290
Office
Unavailable
Facility
$986.62
No comparable office rate is available.
Napa
California · 31290
Office
Unavailable
Facility
$1076.57
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 31290
Office
Unavailable
Facility
$1026.61
No comparable office rate is available.
Redding
California · 31290
Office
Unavailable
Facility
$986.62
No comparable office rate is available.
Rest Of California
California · 31290
Office
Unavailable
Facility
$986.62
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 31290
Office
Unavailable
Facility
$1017.30
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 31290
Office
Unavailable
Facility
$1017.67
No comparable office rate is available.
Salinas
California · 31290
Office
Unavailable
Facility
$1013.47
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 31290
Office
Unavailable
Facility
$1024.22
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 31290
Office
Unavailable
Facility
$1118.13
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 31290
Office
Unavailable
Facility
$1114.91
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 31290
Office
Unavailable
Facility
$1143.86
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 31290
Office
Unavailable
Facility
$1130.67
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 31290
Office
Unavailable
Facility
$999.16
No comparable office rate is available.
Santa Cruz-Watsonville
California · 31290
Office
Unavailable
Facility
$1023.74
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 31290
Office
Unavailable
Facility
$1013.70
No comparable office rate is available.
Santa Rosa-Petaluma
California · 31290
Office
Unavailable
Facility
$1032.99
No comparable office rate is available.
Stockton
California · 31290
Office
Unavailable
Facility
$986.62
No comparable office rate is available.
Vallejo
California · 31290
Office
Unavailable
Facility
$1071.92
No comparable office rate is available.
Visalia
California · 31290
Office
Unavailable
Facility
$986.62
No comparable office rate is available.
Yuba City
California · 31290
Office
Unavailable
Facility
$986.62
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 31290
Office
Unavailable
Facility
$1087.68
No comparable office rate is available.
Miami
Florida · 31290
Office
Unavailable
Facility
$1149.33
No comparable office rate is available.
Chicago
Illinois · 31290
Office
Unavailable
Facility
$1120.88
No comparable office rate is available.
Manhattan
New York · 31290
Office
Unavailable
Facility
$1133.94
No comparable office rate is available.
Alaska*
Alaska · 31290
Office
Unavailable
Facility
$1271.65
No comparable office rate is available.
Alabama
Alabama · 31290
Office
Unavailable
Facility
$914.72
No comparable office rate is available.
Arkansas
Arkansas · 31290
Office
Unavailable
Facility
$905.22
No comparable office rate is available.
Arizona
Arizona · 31290
Office
Unavailable
Facility
$969.64
No comparable office rate is available.
Colorado
Colorado · 31290
Office
Unavailable
Facility
$997.50
No comparable office rate is available.
Connecticut
Connecticut · 31290
Office
Unavailable
Facility
$1046.83
No comparable office rate is available.
Delaware
Delaware · 31290
Office
Unavailable
Facility
$982.29
No comparable office rate is available.
Fort Lauderdale
Florida · 31290
Office
Unavailable
Facility
$1072.78
No comparable office rate is available.
Rest Of Florida
Florida · 31290
Office
Unavailable
Facility
$1027.22
No comparable office rate is available.
Atlanta
Georgia · 31290
Office
Unavailable
Facility
$1017.89
No comparable office rate is available.
Rest Of Georgia
Georgia · 31290
Office
Unavailable
Facility
$979.06
No comparable office rate is available.
Hawaii, Guam
Hawaii · 31290
Office
Unavailable
Facility
$992.35
No comparable office rate is available.
Iowa
Iowa · 31290
Office
Unavailable
Facility
$910.36
No comparable office rate is available.
Idaho
Idaho · 31290
Office
Unavailable
Facility
$919.02
No comparable office rate is available.
East St. Louis
Illinois · 31290
Office
Unavailable
Facility
$1065.20
No comparable office rate is available.
Rest Of Illinois
Illinois · 31290
Office
Unavailable
Facility
$1020.38
No comparable office rate is available.
Suburban Chicago
Illinois · 31290
Office
Unavailable
Facility
$1077.69
No comparable office rate is available.
Indiana
Indiana · 31290
Office
Unavailable
Facility
$922.30
No comparable office rate is available.
Kansas
Kansas · 31290
Office
Unavailable
Facility
$917.30
No comparable office rate is available.
Kentucky
Kentucky · 31290
Office
Unavailable
Facility
$951.91
No comparable office rate is available.
New Orleans
Louisiana · 31290
Office
Unavailable
Facility
$988.04
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 31290
Office
Unavailable
Facility
$954.82
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 31290
Office
Unavailable
Facility
$1063.32
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 31290
Office
Unavailable
Facility
$998.23
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 31290
Office
Unavailable
Facility
$1045.80
No comparable office rate is available.
Rest Of Maryland
Maryland · 31290
Office
Unavailable
Facility
$994.12
No comparable office rate is available.
Rest Of Maine
Maine · 31290
Office
Unavailable
Facility
$933.16
No comparable office rate is available.
Southern Maine
Maine · 31290
Office
Unavailable
Facility
$954.71
No comparable office rate is available.
Detroit
Michigan · 31290
Office
Unavailable
Facility
$1047.21
No comparable office rate is available.
Rest Of Michigan
Michigan · 31290
Office
Unavailable
Facility
$979.21
No comparable office rate is available.
Minnesota
Minnesota · 31290
Office
Unavailable
Facility
$934.02
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 31290
Office
Unavailable
Facility
$972.37
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 31290
Office
Unavailable
Facility
$978.53
No comparable office rate is available.
Rest Of Missouri
Missouri · 31290
Office
Unavailable
Facility
$949.64
No comparable office rate is available.
Mississippi
Mississippi · 31290
Office
Unavailable
Facility
$927.05
No comparable office rate is available.
Montana**
Montana · 31290
Office
Unavailable
Facility
$992.15
No comparable office rate is available.
North Carolina
North Carolina · 31290
Office
Unavailable
Facility
$938.56
No comparable office rate is available.
North Dakota**
North Dakota · 31290
Office
Unavailable
Facility
$935.99
No comparable office rate is available.
Nebraska
Nebraska · 31290
Office
Unavailable
Facility
$910.89
No comparable office rate is available.
New Hampshire
New Hampshire · 31290
Office
Unavailable
Facility
$992.44
No comparable office rate is available.
Northern Nj
New Jersey · 31290
Office
Unavailable
Facility
$1083.62
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 31290
Office
Unavailable
Facility
$1052.60
No comparable office rate is available.
New Mexico
New Mexico · 31290
Office
Unavailable
Facility
$987.21
No comparable office rate is available.
Nevada**
Nevada · 31290
Office
Unavailable
Facility
$976.79
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 31290
Office
Unavailable
Facility
$1167.52
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 31290
Office
Unavailable
Facility
$1067.23
No comparable office rate is available.
Queens
New York · 31290
Office
Unavailable
Facility
$1126.11
No comparable office rate is available.
Rest Of New York
New York · 31290
Office
Unavailable
Facility
$949.59
No comparable office rate is available.
Ohio
Ohio · 31290
Office
Unavailable
Facility
$967.73
No comparable office rate is available.
Oklahoma
Oklahoma · 31290
Office
Unavailable
Facility
$939.99
No comparable office rate is available.
Portland
Oregon · 31290
Office
Unavailable
Facility
$1010.12
No comparable office rate is available.
Rest Of Oregon
Oregon · 31290
Office
Unavailable
Facility
$963.00
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 31290
Office
Unavailable
Facility
$1033.51
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 31290
Office
Unavailable
Facility
$963.21
No comparable office rate is available.
Puerto Rico
Puerto Rico · 31290
Office
Unavailable
Facility
$994.13
No comparable office rate is available.
Rhode Island
Rhode Island · 31290
Office
Unavailable
Facility
$1003.23
No comparable office rate is available.
South Carolina
South Carolina · 31290
Office
Unavailable
Facility
$955.95
No comparable office rate is available.
South Dakota**
South Dakota · 31290
Office
Unavailable
Facility
$929.35
No comparable office rate is available.
Tennessee
Tennessee · 31290
Office
Unavailable
Facility
$921.89
No comparable office rate is available.
Austin
Texas · 31290
Office
Unavailable
Facility
$999.65
No comparable office rate is available.
Beaumont
Texas · 31290
Office
Unavailable
Facility
$959.36
No comparable office rate is available.
Brazoria
Texas · 31290
Office
Unavailable
Facility
$973.69
No comparable office rate is available.
Dallas
Texas · 31290
Office
Unavailable
Facility
$983.16
No comparable office rate is available.
Fort Worth
Texas · 31290
Office
Unavailable
Facility
$981.47
No comparable office rate is available.
Galveston
Texas · 31290
Office
Unavailable
Facility
$978.83
No comparable office rate is available.
Houston
Texas · 31290
Office
Unavailable
Facility
$1030.81
No comparable office rate is available.
Rest Of Texas
Texas · 31290
Office
Unavailable
Facility
$968.27
No comparable office rate is available.
Utah
Utah · 31290
Office
Unavailable
Facility
$965.17
No comparable office rate is available.
Virginia
Virginia · 31290
Office
Unavailable
Facility
$959.50
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 31290
Office
Unavailable
Facility
$994.13
No comparable office rate is available.
Vermont
Vermont · 31290
Office
Unavailable
Facility
$942.56
No comparable office rate is available.
Rest Of Washington
Washington · 31290
Office
Unavailable
Facility
$993.00
No comparable office rate is available.
Seattle (King Cnty)
Washington · 31290
Office
Unavailable
Facility
$1071.47
No comparable office rate is available.
Wisconsin
Wisconsin · 31290
Office
Unavailable
Facility
$914.45
No comparable office rate is available.
West Virginia
West Virginia · 31290
Office
Unavailable
Facility
$995.03
No comparable office rate is available.
Wyoming**
Wyoming · 31290
Office
Unavailable
Facility
$967.68
No comparable office rate is available.
See how rates vary across the country
31290 · 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?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 31290 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1085.28
$986.62 × 110% = $1085.28
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 31290 in Merced.
PPRRVU2026_Oct_nonQPP.csv
3,545
- Code
- 31290
- Physician work
- 18.14
- Practice expense
- 8.73
- Malpractice
- 2.84
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.14 | × 1.017 | 18.4484 |
| Practice expense | 8.73 | × 1.096 | 9.5681 |
| Malpractice | 2.84 | × 0.536 | 1.5222 |
| Total RVUs | 29.5387 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$986.62
Open 31290 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.14 | 1.017 |
| Practice expense | 8.73 | 1.096 |
| Malpractice | 2.84 | 0.536 |
(18.14 × 1.017 + 8.73 × 1.096 + 2.84 × 0.536) × $33.4009 = $986.62
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
31290 · 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 | $986.62 | RVU26D |
| 2026-07-01 | Not available in this setting | $986.62 | RVU26C |
| 2026-04-01 | Not available in this setting | $986.62 | RVU26B |
| 2026-01-01 | Not available in this setting | $986.62 | RVU26A |
| 2025-10-01 | Not available in this setting | $1118.69 | RVU25D |
| 2025-07-01 | Not available in this setting | $1118.69 | RVU25C |
| 2025-04-01 | Not available in this setting | $1118.69 | RVU25B |
| 2025-01-01 | Not available in this setting | $1118.69 | RVU25A |
31290 billing questions
How is 31290 distinguished from 31291?
31290 is for endoscopic CSF leak repair in the ethmoid region. Use 31291 when the documented leak site is the sphenoid region.
Is an ethmoidectomy the same service as 31290?
No. An ethmoidectomy removes ethmoid sinus tissue, while 31290 reports endoscopic repair of a CSF leak at the ethmoid region. Select the code from the documented procedure.
How should bilateral repair be reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Are postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the 10-day global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.
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.
3,54231276,,Nsl/sins ndsc frnt tiss rmvl,A,,6.58,1.98,NA,1.98,,0.96,9.52,9.52,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54331287,,Nasal/sinus endoscopy surg,A,,3.41,1.21,NA,1.21,,0.48,5.10,5.10,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54431288,,Nasal/sinus endoscopy surg,A,,4.00,1.35,NA,1.35,,0.58,5.93,5.93,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54531290,,Nasal/sinus endoscopy surg,A,,18.14,8.73,NA,8.73,,2.84,29.71,29.71,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54631291,,Nasal/sinus endoscopy surg,A,,19.07,9.50,NA,9.50,,3.67,32.24,32.24,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54731292,,Nsl/sins ndsc med/inf dcmprn,A,,15.50,7.80,NA,7.80,,2.28,25.58,25.58,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54831293,,Nsl/sins ndsc med&inf dcmprn,A,,17.03,8.12,NA,8.12,,2.49,27.64,27.64,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623