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CMS RVU26D · Effective 2026-10-01

31020 in Modesto

Office / nonfacility

$458.52

Base rate per service

Facility setting

$343.58

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.

Sinus surgery

About 31020: Intranasal maxillary sinusotomy

Reports surgical opening of a maxillary sinus through the nasal cavity when treatment requires more than irrigation or a different surgical approach.

CPT 31020 represents surgical access to a maxillary sinus through the nasal cavity to open or enlarge its drainage pathway. An otolaryngologist typically performs the procedure for maxillary sinus disease requiring operative drainage or access, rather than a simple sinus rinse. The code identifies the intranasal approach; it is distinct from a Caldwell-Luc operation and from endoscopic maxillary procedures reported with endoscopy-specific codes.

Select the code when the operative report supports an intranasal maxillary sinusotomy. Document the side, approach, operative work, and relevant findings so the service can be distinguished from irrigation, a different approach, or removal of a polyp. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral surgery and is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 31020

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
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 RVU2.99 · 23%
  • Practice expense (office) RVU9.57 · 74%
  • Malpractice RVU0.37 · 3%

283

Medicare services in 2024 · #4035 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.

31020 compared with similar codes

Office rates for Modesto, from the same CMS release.

31000

Sinus irrigation

Maxillary sinus

$200.02

31000 is maxillary sinus irrigation. Choose 31020 when the surgeon creates or enlarges a surgical opening through the nasal cavity.

31030

Sinus exploration

Maxillary, intranasal

$684.89

Both address the maxillary sinus, but 31030 uses a Caldwell-Luc approach. Code 31020 describes the intranasal approach.

31256

Maxillary antrostomy

Without tissue removal

No office rate

31256 is for endoscopic maxillary antrostomy. Use 31020 for the intranasal sinusotomy when the documented procedure is not reported as an endoscopic antrostomy.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 31020 is $459.63—$1.11 higher than the $458.52 rate in Modesto. Both use the same code, release and participation basis.

31020 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $458.52

  2. Bakersfield

    $459.63

    $1.11 higher than Modesto

  3. Chico

    $458.52

    The same base rate than Modesto

  4. El Centro

    $458.59

    $0.07 higher than Modesto

  5. Fresno

    $458.52

    The same base rate than Modesto

  6. Hanford-Corcoran

    $458.52

    The same base rate than Modesto

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

    $490.31

    $31.79 higher than Modesto

Other payment areas listed in California 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, 31020 ranges from $380.81 in Arkansas to $578.41 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

  • Madera

    California · 31020

    Office

    $458.52

    Facility

    $343.58

    The same base rate than Modesto for the office setting.

  • Merced

    California · 31020

    Office

    $458.52

    Facility

    $343.58

    The same base rate than Modesto for the office setting.

  • Napa

    California · 31020

    Office

    $533.73

    Facility

    $395.50

    $75.21 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 31020

    Office

    $488.19

    Facility

    $364.22

    $29.67 higher than Modesto for the office setting.

  • Redding

    California · 31020

    Office

    $458.52

    Facility

    $343.58

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 31020

    Office

    $458.52

    Facility

    $343.58

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 31020

    Office

    $462.54

    Facility

    $347.59

    $4.02 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 31020

    Office

    $481.84

    Facility

    $359.86

    $23.32 higher than Modesto for the office setting.

  • Salinas

    California · 31020

    Office

    $480.06

    Facility

    $358.50

    $21.54 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 31020

    Office

    $491.86

    Facility

    $366.43

    $33.34 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 31020

    Office

    $565.73

    Facility

    $417.85

    $107.21 higher than Modesto for the office setting.

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

    California · 31020

    Office

    $565.31

    Facility

    $417.43

    $106.79 higher than Modesto for the office setting.

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

    California · 31020

    Office

    $578.41

    Facility

    $427.17

    $119.89 higher than Modesto for the office setting.

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

    California · 31020

    Office

    $576.69

    Facility

    $425.46

    $118.17 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 31020

    Office

    $472.27

    Facility

    $352.81

    $13.75 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 31020

    Office

    $496.96

    Facility

    $369.53

    $38.44 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 31020

    Office

    $482.00

    Facility

    $359.71

    $23.48 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 31020

    Office

    $502.01

    Facility

    $373.22

    $43.49 higher than Modesto for the office setting.

  • Stockton

    California · 31020

    Office

    $458.52

    Facility

    $343.58

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 31020

    Office

    $533.13

    Facility

    $394.90

    $74.61 higher than Modesto for the office setting.

  • Visalia

    California · 31020

    Office

    $458.52

    Facility

    $343.58

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 31020

    Office

    $458.52

    Facility

    $343.58

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 31020

    Office

    $495.56

    Facility

    $372.01

    $37.04 higher than Modesto for the office setting.

  • Miami

    Florida · 31020

    Office

    $463.88

    Facility

    $354.70

    $5.36 higher than Modesto for the office setting.

  • Chicago

    Illinois · 31020

    Office

    $450.17

    Facility

    $344.77

    $8.35 lower than Modesto for the office setting.

  • Manhattan

    New York · 31020

    Office

    $497.29

    Facility

    $375.42

    $38.77 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 31020

    Office

    $497.04

    Facility

    $385.34

    $38.52 higher than Modesto for the office setting.

  • Alabama

    Alabama · 31020

    Office

    $386.55

    Facility

    $294.79

    $71.97 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 31020

    Office

    $380.81

    Facility

    $290.72

    $77.71 lower than Modesto for the office setting.

  • Arizona

    Arizona · 31020

    Office

    $420.18

    Facility

    $318.56

    $38.34 lower than Modesto for the office setting.

  • Colorado

    Colorado · 31020

    Office

    $450.82

    Facility

    $339.23

    $7.70 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 31020

    Office

    $461.08

    Facility

    $348.12

    $2.56 higher than Modesto for the office setting.

  • Delaware

    Delaware · 31020

    Office

    $427.29

    Facility

    $323.67

    $31.23 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 31020

    Office

    $446.01

    Facility

    $339.77

    $12.51 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 31020

    Office

    $424.03

    Facility

    $323.76

    $34.49 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 31020

    Office

    $439.77

    Facility

    $333.21

    $18.75 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 31020

    Office

    $399.72

    Facility

    $306.17

    $58.80 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 31020

    Office

    $470.46

    Facility

    $351.22

    $11.94 higher than Modesto for the office setting.

  • Iowa

    Iowa · 31020

    Office

    $397.25

    Facility

    $301.29

    $61.27 lower than Modesto for the office setting.

  • Idaho

    Idaho · 31020

    Office

    $399.79

    Facility

    $303.30

    $58.73 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 31020

    Office

    $418.83

    Facility

    $322.34

    $39.69 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 31020

    Office

    $411.02

    Facility

    $315.27

    $47.50 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 31020

    Office

    $450.74

    Facility

    $343.03

    $7.78 lower than Modesto for the office setting.

  • Indiana

    Indiana · 31020

    Office

    $402.19

    Facility

    $304.96

    $56.33 lower than Modesto for the office setting.

  • Kansas

    Kansas · 31020

    Office

    $395.06

    Facility

    $300.25

    $63.46 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 31020

    Office

    $395.34

    Facility

    $302.11

    $63.18 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 31020

    Office

    $414.70

    Facility

    $316.00

    $43.82 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 31020

    Office

    $394.60

    Facility

    $301.78

    $63.92 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 31020

    Office

    $496.62

    Facility

    $371.39

    $38.10 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 31020

    Office

    $447.90

    Facility

    $337.47

    $10.62 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 31020

    Office

    $459.73

    Facility

    $347.20

    $1.21 higher than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 31020

    Office

    $435.69

    Facility

    $329.56

    $22.83 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 31020

    Office

    $401.63

    Facility

    $305.14

    $56.89 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 31020

    Office

    $424.44

    Facility

    $320.50

    $34.08 lower than Modesto for the office setting.

  • Detroit

    Michigan · 31020

    Office

    $429.16

    Facility

    $327.96

    $29.36 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 31020

    Office

    $405.66

    Facility

    $309.90

    $52.86 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 31020

    Office

    $432.44

    Facility

    $324.52

    $26.08 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 31020

    Office

    $412.09

    Facility

    $313.61

    $46.43 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 31020

    Office

    $416.56

    Facility

    $316.71

    $41.96 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 31020

    Office

    $387.44

    Facility

    $297.04

    $71.08 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 31020

    Office

    $384.22

    Facility

    $293.92

    $74.30 lower than Modesto for the office setting.

  • Montana**

    Montana · 31020

    Office

    $431.85

    Facility

    $326.97

    $26.67 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 31020

    Office

    $406.00

    Facility

    $308.14

    $52.52 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 31020

    Office

    $424.53

    Facility

    $319.65

    $33.99 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 31020

    Office

    $399.57

    Facility

    $302.77

    $58.95 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 31020

    Office

    $443.43

    Facility

    $334.26

    $15.09 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 31020

    Office

    $490.15

    Facility

    $368.49

    $31.63 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 31020

    Office

    $466.47

    Facility

    $351.95

    $7.95 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 31020

    Office

    $407.83

    Facility

    $311.65

    $50.69 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 31020

    Office

    $430.13

    Facility

    $325.15

    $28.39 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 31020

    Office

    $509.27

    Facility

    $384.57

    $50.75 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 31020

    Office

    $469.33

    Facility

    $354.49

    $10.81 higher than Modesto for the office setting.

  • Queens

    New York · 31020

    Office

    $501.90

    Facility

    $377.94

    $43.38 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 31020

    Office

    $412.22

    Facility

    $312.59

    $46.30 lower than Modesto for the office setting.

  • Ohio

    Ohio · 31020

    Office

    $404.16

    Facility

    $308.41

    $54.36 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 31020

    Office

    $394.92

    Facility

    $301.26

    $63.60 lower than Modesto for the office setting.

  • Portland

    Oregon · 31020

    Office

    $465.79

    Facility

    $349.27

    $7.27 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 31020

    Office

    $426.92

    Facility

    $322.47

    $31.60 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 31020

    Office

    $449.16

    Facility

    $339.98

    $9.36 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 31020

    Office

    $404.98

    Facility

    $308.70

    $53.54 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 31020

    Office

    $435.20

    Facility

    $329.17

    $23.32 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 31020

    Office

    $442.98

    Facility

    $334.64

    $15.54 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 31020

    Office

    $405.73

    Facility

    $308.82

    $52.79 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 31020

    Office

    $423.67

    Facility

    $318.79

    $34.85 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 31020

    Office

    $397.06

    Facility

    $301.73

    $61.46 lower than Modesto for the office setting.

  • Austin

    Texas · 31020

    Office

    $449.20

    Facility

    $338.24

    $9.32 lower than Modesto for the office setting.

  • Beaumont

    Texas · 31020

    Office

    $402.23

    Facility

    $306.79

    $56.29 lower than Modesto for the office setting.

  • Brazoria

    Texas · 31020

    Office

    $427.08

    Facility

    $323.14

    $31.44 lower than Modesto for the office setting.

  • Dallas

    Texas · 31020

    Office

    $429.74

    Facility

    $325.28

    $28.78 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 31020

    Office

    $426.70

    Facility

    $323.29

    $31.82 lower than Modesto for the office setting.

  • Galveston

    Texas · 31020

    Office

    $428.31

    Facility

    $324.16

    $30.21 lower than Modesto for the office setting.

  • Houston

    Texas · 31020

    Office

    $435.08

    Facility

    $330.94

    $23.44 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 31020

    Office

    $414.37

    Facility

    $314.84

    $44.15 lower than Modesto for the office setting.

  • Utah

    Utah · 31020

    Office

    $411.43

    Facility

    $312.85

    $47.09 lower than Modesto for the office setting.

  • Virginia

    Virginia · 31020

    Office

    $422.81

    Facility

    $319.71

    $35.71 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 31020

    Office

    $435.20

    Facility

    $329.17

    $23.32 lower than Modesto for the office setting.

  • Vermont

    Vermont · 31020

    Office

    $422.57

    Facility

    $318.74

    $35.95 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 31020

    Office

    $447.16

    Facility

    $336.72

    $11.36 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 31020

    Office

    $507.17

    Facility

    $378.48

    $48.65 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 31020

    Office

    $409.90

    Facility

    $309.42

    $48.62 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 31020

    Office

    $395.33

    Facility

    $304.19

    $63.19 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 31020

    Office

    $428.66

    Facility

    $323.78

    $29.86 lower than Modesto for the office setting.

See how rates vary across the country

31020 · 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.

$380.81

$518.46

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$497.041
AL$386.551
AR$380.811
AZ$420.181
CA$458.52–$578.4129
CO$450.821
CT$461.081
DC$495.561
DE$427.291
FL$424.03–$463.883
GA$399.72–$439.772
GU$470.461
HI$470.461
IA$397.251
ID$399.791
IL$411.02–$450.744
IN$402.191
KS$395.061
KY$395.341
LA$394.60–$414.702
MA$447.90–$496.622
MD$435.69–$495.563
ME$401.63–$424.442
MI$405.66–$429.162
MN$432.441
MO$387.44–$416.563
MS$384.221
MT$431.851
NC$406.001
ND$424.531
NE$399.571
NH$443.431
NJ$466.47–$490.152
NM$407.831
NV$430.131
NY$412.22–$509.275
OH$404.161
OK$394.921
OR$426.92–$465.792
PA$404.98–$449.162
PR$435.201
RI$442.981
SC$405.731
SD$423.671
TN$397.061
TX$402.23–$449.208
UT$411.431
VA$422.81–$495.562
VI$435.201
VT$422.571
WA$447.16–$507.172
WI$409.901
WV$395.331
WY$428.661

Explore 31020 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 31020 in Modesto, the physician’s office rate is $458.52 and the facility-setting rate is $343.58: a difference of $114.94.

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 31020 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$504.37

$458.52 × 110% = $504.37

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.

Compare your contract offer →

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 31020 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

3,496

Code
31020
Physician work
2.99
Practice expense
9.57
Malpractice
0.37

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 31020 in Modesto
ComponentRVULocality factorAdjusted
Physician work2.99× 1.0173.0408
Practice expense9.57× 1.09610.4887
Malpractice0.37× 0.5360.1983
Total RVUs13.7279
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$458.52

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

Open 31020 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.991.017
Practice expense9.571.096
Malpractice0.370.536

(2.99 × 1.017 + 9.57 × 1.096 + 0.37 × 0.536) × $33.4009 = $458.52

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.991.017
Practice expense6.431.096
Malpractice0.370.536

(2.99 × 1.017 + 6.43 × 1.096 + 0.37 × 0.536) × $33.4009 = $343.58

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

31020 · Office / nonfacility

$458.52

Effective 2026-10-01

The base rate is $21.81 higher than on 2025-10-01, moving from $436.71 to $458.52 (5.0%).

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

    $436.71changed to$458.52

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.07 changed to 2.99
    • Practice expense RVU 9.33 changed to 9.57
    • Malpractice RVU 0.34 changed to 0.37
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $436.71

    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$458.52$343.58RVU26D
2026-07-01$458.52$343.58RVU26C
2026-04-01$458.52$343.58RVU26B
2026-01-01$458.52$343.58RVU26A
2025-10-01$436.71$353.28RVU25D
2025-07-01$436.71$353.28RVU25C
2025-04-01$436.71$353.28RVU25B
2025-01-01$436.71$353.28RVU25A

31020 billing questions

How is 31020 different from 31030?

31020 describes access through the nasal cavity. 31030 is the maxillary sinus procedure performed through a Caldwell-Luc approach.

When should 31020 be used instead of 31000?

Use 31020 for surgical opening of the maxillary sinus. Code 31000 describes irrigation, not creation of a surgical opening.

How does 31020 differ from endoscopic maxillary antrostomy?

31020 identifies an intranasal sinusotomy. When the surgeon performs the maxillary antrostomy using nasal endoscopy, consider the endoscopic code that matches the work, such as 31256 or 31267 when tissue is removed.

How is bilateral 31020 reported?

For bilateral surgery, report modifier 50 under the CMS bilateral rule; payment is at 150%.

Can an assistant surgeon or co-surgeon be paid for 31020?

CMS restricts assistant-at-surgery payment 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.

RVUs for 31020PPRRVU2026_Oct_nonQPP.csv, line 3,496 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet