No office rate
31255 represents total ethmoidectomy without sphenoidotomy. Choose 31257 when the surgeon also creates an opening into the sphenoid sinus.
On this page
CMS RVU26D · Effective 2026-10-01
31257 in Redding
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$369.20
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.
Otolaryngology surgery
About 31257: Total ethmoidectomy with sphenoidotomy
Reports endoscopic removal of anterior and posterior ethmoid tissue with an opening into the sphenoid sinus during surgical treatment of chronic sinus disease.
An otolaryngologist performs this endoscopic operation to remove ethmoid air-cell tissue from both the anterior and posterior portions of the ethmoid sinus and create an opening into the sphenoid sinus. It may be part of surgery for chronic rhinosinusitis when disease involves both sinus regions. The sphenoid sinus is opened, but removal of tissue from within that sinus is not part of this code’s distinguishing service.
Select the code when the operative report supports the complete ethmoidectomy and sphenoidotomy; distinguish it from a sphenoid procedure that also removes sphenoid tissue. Document the treated sides and the work performed in each sinus. The procedure 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 reporting, modifier 50 is paid at 150%. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 31257
- 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 RVU7.80 · 69%
- Practice expense (office) RVU2.29 · 20%
- Malpractice RVU1.14 · 10%
5.3K
Medicare services in 2024 · #1828 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.
31257 compared with similar codes
Office rates for Redding, from the same CMS release.
No office rate
31259 includes removal of tissue from within the sphenoid sinus; 31257 describes sphenoidotomy without that tissue-removal element.
No office rate
31287 covers sphenoidotomy without total ethmoidectomy. Use 31257 when the surgeon performs both sphenoidotomy and total ethmoidectomy.
No office rate
31253 pairs total ethmoidectomy with frontal sinus work. Code 31257 pairs total ethmoidectomy with sphenoidotomy instead.
The same code, a different location
How does Redding compare?
31257 across payment areas
Same release and payment basis · bars start at $0
Redding · 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 · 31257
Office
Unavailable
Facility
$369.20
No comparable office rate is available.
Merced
California · 31257
Office
Unavailable
Facility
$369.20
No comparable office rate is available.
Modesto
California · 31257
Office
Unavailable
Facility
$369.20
No comparable office rate is available.
Napa
California · 31257
Office
Unavailable
Facility
$397.09
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 31257
Office
Unavailable
Facility
$381.95
No comparable office rate is available.
Rest Of California
California · 31257
Office
Unavailable
Facility
$369.20
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 31257
Office
Unavailable
Facility
$381.53
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 31257
Office
Unavailable
Facility
$379.27
No comparable office rate is available.
Salinas
California · 31257
Office
Unavailable
Facility
$377.66
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 31257
Office
Unavailable
Facility
$380.46
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 31257
Office
Unavailable
Facility
$410.60
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 31257
Office
Unavailable
Facility
$409.31
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 31257
Office
Unavailable
Facility
$419.89
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 31257
Office
Unavailable
Facility
$414.60
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 31257
Office
Unavailable
Facility
$372.49
No comparable office rate is available.
Santa Cruz-Watsonville
California · 31257
Office
Unavailable
Facility
$379.34
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 31257
Office
Unavailable
Facility
$377.42
No comparable office rate is available.
Santa Rosa-Petaluma
California · 31257
Office
Unavailable
Facility
$382.68
No comparable office rate is available.
Stockton
California · 31257
Office
Unavailable
Facility
$369.20
No comparable office rate is available.
Vallejo
California · 31257
Office
Unavailable
Facility
$395.23
No comparable office rate is available.
Visalia
California · 31257
Office
Unavailable
Facility
$369.20
No comparable office rate is available.
Yuba City
California · 31257
Office
Unavailable
Facility
$369.20
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 31257
Office
Unavailable
Facility
$407.08
No comparable office rate is available.
Miami
Florida · 31257
Office
Unavailable
Facility
$436.45
No comparable office rate is available.
Chicago
Illinois · 31257
Office
Unavailable
Facility
$426.61
No comparable office rate is available.
Manhattan
New York · 31257
Office
Unavailable
Facility
$426.47
No comparable office rate is available.
Alaska*
Alaska · 31257
Office
Unavailable
Facility
$493.23
No comparable office rate is available.
Alabama
Alabama · 31257
Office
Unavailable
Facility
$349.01
No comparable office rate is available.
Arkansas
Arkansas · 31257
Office
Unavailable
Facility
$345.84
No comparable office rate is available.
Arizona
Arizona · 31257
Office
Unavailable
Facility
$367.24
No comparable office rate is available.
Colorado
Colorado · 31257
Office
Unavailable
Facility
$374.77
No comparable office rate is available.
Connecticut
Connecticut · 31257
Office
Unavailable
Facility
$394.19
No comparable office rate is available.
Delaware
Delaware · 31257
Office
Unavailable
Facility
$371.63
No comparable office rate is available.
Fort Lauderdale
Florida · 31257
Office
Unavailable
Facility
$406.85
No comparable office rate is available.
Rest Of Florida
Florida · 31257
Office
Unavailable
Facility
$390.88
No comparable office rate is available.
Atlanta
Georgia · 31257
Office
Unavailable
Facility
$384.75
No comparable office rate is available.
Rest Of Georgia
Georgia · 31257
Office
Unavailable
Facility
$374.14
No comparable office rate is available.
Hawaii, Guam
Hawaii · 31257
Office
Unavailable
Facility
$369.54
No comparable office rate is available.
Iowa
Iowa · 31257
Office
Unavailable
Facility
$345.63
No comparable office rate is available.
Idaho
Idaho · 31257
Office
Unavailable
Facility
$348.91
No comparable office rate is available.
East St. Louis
Illinois · 31257
Office
Unavailable
Facility
$407.58
No comparable office rate is available.
Rest Of Illinois
Illinois · 31257
Office
Unavailable
Facility
$389.88
No comparable office rate is available.
Suburban Chicago
Illinois · 31257
Office
Unavailable
Facility
$408.38
No comparable office rate is available.
Indiana
Indiana · 31257
Office
Unavailable
Facility
$349.94
No comparable office rate is available.
Kansas
Kansas · 31257
Office
Unavailable
Facility
$348.86
No comparable office rate is available.
Kentucky
Kentucky · 31257
Office
Unavailable
Facility
$363.37
No comparable office rate is available.
New Orleans
Louisiana · 31257
Office
Unavailable
Facility
$375.76
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 31257
Office
Unavailable
Facility
$364.70
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 31257
Office
Unavailable
Facility
$396.42
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 31257
Office
Unavailable
Facility
$375.58
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 31257
Office
Unavailable
Facility
$393.87
No comparable office rate is available.
Rest Of Maryland
Maryland · 31257
Office
Unavailable
Facility
$375.49
No comparable office rate is available.
Rest Of Maine
Maine · 31257
Office
Unavailable
Facility
$354.58
No comparable office rate is available.
Southern Maine
Maine · 31257
Office
Unavailable
Facility
$360.35
No comparable office rate is available.
Detroit
Michigan · 31257
Office
Unavailable
Facility
$398.54
No comparable office rate is available.
Rest Of Michigan
Michigan · 31257
Office
Unavailable
Facility
$373.35
No comparable office rate is available.
Minnesota
Minnesota · 31257
Office
Unavailable
Facility
$350.50
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 31257
Office
Unavailable
Facility
$369.55
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 31257
Office
Unavailable
Facility
$371.50
No comparable office rate is available.
Rest Of Missouri
Missouri · 31257
Office
Unavailable
Facility
$363.55
No comparable office rate is available.
Mississippi
Mississippi · 31257
Office
Unavailable
Facility
$354.52
No comparable office rate is available.
Montana**
Montana · 31257
Office
Unavailable
Facility
$375.02
No comparable office rate is available.
North Carolina
North Carolina · 31257
Office
Unavailable
Facility
$356.22
No comparable office rate is available.
North Dakota**
North Dakota · 31257
Office
Unavailable
Facility
$352.47
No comparable office rate is available.
Nebraska
Nebraska · 31257
Office
Unavailable
Facility
$345.52
No comparable office rate is available.
New Hampshire
New Hampshire · 31257
Office
Unavailable
Facility
$373.47
No comparable office rate is available.
Northern Nj
New Jersey · 31257
Office
Unavailable
Facility
$406.33
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 31257
Office
Unavailable
Facility
$396.24
No comparable office rate is available.
New Mexico
New Mexico · 31257
Office
Unavailable
Facility
$376.40
No comparable office rate is available.
Nevada**
Nevada · 31257
Office
Unavailable
Facility
$368.81
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 31257
Office
Unavailable
Facility
$438.85
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 31257
Office
Unavailable
Facility
$402.08
No comparable office rate is available.
Queens
New York · 31257
Office
Unavailable
Facility
$422.52
No comparable office rate is available.
Rest Of New York
New York · 31257
Office
Unavailable
Facility
$359.96
No comparable office rate is available.
Ohio
Ohio · 31257
Office
Unavailable
Facility
$368.74
No comparable office rate is available.
Oklahoma
Oklahoma · 31257
Office
Unavailable
Facility
$358.42
No comparable office rate is available.
Portland
Oregon · 31257
Office
Unavailable
Facility
$378.00
No comparable office rate is available.
Rest Of Oregon
Oregon · 31257
Office
Unavailable
Facility
$363.48
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 31257
Office
Unavailable
Facility
$390.27
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 31257
Office
Unavailable
Facility
$366.73
No comparable office rate is available.
Puerto Rico
Puerto Rico · 31257
Office
Unavailable
Facility
$375.36
No comparable office rate is available.
Rhode Island
Rhode Island · 31257
Office
Unavailable
Facility
$378.45
No comparable office rate is available.
South Carolina
South Carolina · 31257
Office
Unavailable
Facility
$363.57
No comparable office rate is available.
South Dakota**
South Dakota · 31257
Office
Unavailable
Facility
$349.81
No comparable office rate is available.
Tennessee
Tennessee · 31257
Office
Unavailable
Facility
$350.50
No comparable office rate is available.
Austin
Texas · 31257
Office
Unavailable
Facility
$375.71
No comparable office rate is available.
Beaumont
Texas · 31257
Office
Unavailable
Facility
$365.50
No comparable office rate is available.
Brazoria
Texas · 31257
Office
Unavailable
Facility
$368.11
No comparable office rate is available.
Dallas
Texas · 31257
Office
Unavailable
Facility
$371.72
No comparable office rate is available.
Fort Worth
Texas · 31257
Office
Unavailable
Facility
$371.45
No comparable office rate is available.
Galveston
Texas · 31257
Office
Unavailable
Facility
$370.09
No comparable office rate is available.
Houston
Texas · 31257
Office
Unavailable
Facility
$390.96
No comparable office rate is available.
Rest Of Texas
Texas · 31257
Office
Unavailable
Facility
$367.50
No comparable office rate is available.
Utah
Utah · 31257
Office
Unavailable
Facility
$366.62
No comparable office rate is available.
Virginia
Virginia · 31257
Office
Unavailable
Facility
$362.60
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 31257
Office
Unavailable
Facility
$375.36
No comparable office rate is available.
Vermont
Vermont · 31257
Office
Unavailable
Facility
$355.52
No comparable office rate is available.
Rest Of Washington
Washington · 31257
Office
Unavailable
Facility
$373.43
No comparable office rate is available.
Seattle (King Cnty)
Washington · 31257
Office
Unavailable
Facility
$398.51
No comparable office rate is available.
Wisconsin
Wisconsin · 31257
Office
Unavailable
Facility
$345.53
No comparable office rate is available.
West Virginia
West Virginia · 31257
Office
Unavailable
Facility
$381.48
No comparable office rate is available.
Wyoming**
Wyoming · 31257
Office
Unavailable
Facility
$365.19
No comparable office rate is available.
See how rates vary across the country
31257 · 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?
Redding is a Medicare payment area. Our Census mapping connects it to 32 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 31257 in Redding. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$406.12
$369.20 × 110% = $406.12
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 31257 in Redding.
PPRRVU2026_Oct_nonQPP.csv
3,538
- Code
- 31257
- Physician work
- 7.80
- Practice expense
- 2.29
- Malpractice
- 1.14
GPCI2026.csv
19
- Locality
- Redding
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.80 | × 1.017 | 7.9326 |
| Practice expense | 2.29 | × 1.096 | 2.5098 |
| Malpractice | 1.14 | × 0.536 | 0.6110 |
| Total RVUs | 11.0535 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Redding$369.20
Open 31257 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.8 | 1.017 |
| Practice expense | 2.29 | 1.096 |
| Malpractice | 1.14 | 0.536 |
(7.8 × 1.017 + 2.29 × 1.096 + 1.14 × 0.536) × $33.4009 = $369.20
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
31257 · 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 | $369.20 | RVU26D |
| 2026-07-01 | Not available in this setting | $369.20 | RVU26C |
| 2026-04-01 | Not available in this setting | $369.20 | RVU26B |
| 2026-01-01 | Not available in this setting | $369.20 | RVU26A |
| 2025-10-01 | Not available in this setting | $430.30 | RVU25D |
| 2025-07-01 | Not available in this setting | $430.30 | RVU25C |
| 2025-04-01 | Not available in this setting | $430.30 | RVU25B |
| 2025-01-01 | Not available in this setting | $430.30 | RVU25A |
31257 billing questions
How is this different from 31259?
31259 includes removal of tissue from the sphenoid sinus in addition to the total ethmoidectomy and sphenoidotomy. Use 31257 when the sphenoid sinus is opened but sphenoid tissue removal is not performed.
Can 31255 be reported with 31257 for the same ethmoidectomy?
31257 already includes total ethmoidectomy. Do not separately report 31255 for that same ethmoid work.
What documentation supports reporting 31257?
The operative report should establish removal of anterior and posterior ethmoid tissue and creation of an opening into the sphenoid sinus. Document the side or sides treated and whether tissue was removed from within the sphenoid sinus.
How should bilateral surgery be reported?
Report bilateral surgery with modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay for an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when other related sinus endoscopies are performed in the same session?
Endoscopy family pricing applies when related endoscopies are performed together. The 0-day global period includes same-day preoperative and postoperative care.
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.
3,53531254,,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
3,53831257,,Nsl/sins ndsc tot w/sphendt,A,,7.80,2.29,NA,2.29,,1.14,11.23,11.23,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53931259,,Nsl/sins ndsc sphn tiss rmvl,A,,8.27,2.40,NA,2.40,,1.22,11.89,11.89,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54031267,,Endoscopy maxillary sinus,A,,4.56,1.49,NA,1.49,,0.66,6.71,6.71,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,5413126F,,Esoph bx rprt w/dyspl info,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
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
1901112,CA,61,REDDING,1.017,1.096,0.536
2001112,CA,62,RIVERSIDE-SAN BERNARDINO-ONTARIO,1.018,1.096,0.853
2101112,CA,63,SACRAMENTO-ROSEVILLE-FOLSOM,1.036,1.163,0.536
2201112,CA,64,SALINAS,1.031,1.159,0.536