$428.66
Choose 31040 for exploration of the pterygomaxillary fossa behind the upper jaw. Code 31020 concerns a maxillary sinus procedure.
On this page
CMS RVU26D · Effective 2026-10-01
31040 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$709.37
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 and skull base surgery
About 31040: Pterygomaxillary fossa exploration
Operative exploration of the pterygomaxillary fossa behind the upper jaw, reported when the surgeon directly investigates this deep space.
This operation gives the surgeon access to and permits direct inspection of the pterygomaxillary fossa, a deep space behind the upper jaw. It is distinct from opening or irrigating a paranasal sinus. Otolaryngologists and oral and maxillofacial or head and neck surgeons may perform it in an operating room, generally in a facility setting. The operative report should identify the fossa as the target and describe the approach and exploration performed.
Report 31040 when the documented service is exploration of this space, rather than a maxillary or sphenoid sinus procedure. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is paid at 150% for bilateral procedures. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 31040
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.53 · 44%
- Practice expense (office) RVU10.65 · 49%
- Malpractice RVU1.43 · 7%
144
Medicare services in 2024 · #4594 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.
31040 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
$645.55
Code 31030 describes a radical maxillary sinus procedure; 31040 targets exploration of the adjacent pterygomaxillary fossa.
No office rate
Code 31050 targets the sphenoid sinus. Use 31040 when the operative exploration is of the pterygomaxillary fossa.
The same code, a different location
How does Wyoming** compare?
31040 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming 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
Alabama
Alabama · 31040
Office
Unavailable
Facility
$656.60
No comparable office rate is available.
Arkansas
Arkansas · 31040
Office
Unavailable
Facility
$648.47
No comparable office rate is available.
Arizona
Arizona · 31040
Office
Unavailable
Facility
$703.89
No comparable office rate is available.
Bakersfield
California · 31040
Office
Unavailable
Facility
$743.31
No comparable office rate is available.
Chico
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
El Centro
California · 31040
Office
Unavailable
Facility
$739.43
No comparable office rate is available.
Fresno
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Hanford-Corcoran
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Madera
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Merced
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Modesto
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Napa
California · 31040
Office
Unavailable
Facility
$831.47
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 31040
Office
Unavailable
Facility
$777.44
No comparable office rate is available.
Redding
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Rest Of California
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 31040
Office
Unavailable
Facility
$754.65
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 31040
Office
Unavailable
Facility
$769.07
No comparable office rate is available.
Salinas
California · 31040
Office
Unavailable
Facility
$766.06
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 31040
Office
Unavailable
Facility
$779.19
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 31040
Office
Unavailable
Facility
$872.04
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 31040
Office
Unavailable
Facility
$870.41
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 31040
Office
Unavailable
Facility
$891.87
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 31040
Office
Unavailable
Facility
$885.23
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 31040
Office
Unavailable
Facility
$754.49
No comparable office rate is available.
Santa Cruz-Watsonville
California · 31040
Office
Unavailable
Facility
$782.80
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 31040
Office
Unavailable
Facility
$767.59
No comparable office rate is available.
Santa Rosa-Petaluma
California · 31040
Office
Unavailable
Facility
$790.28
No comparable office rate is available.
Stockton
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Vallejo
California · 31040
Office
Unavailable
Facility
$829.13
No comparable office rate is available.
Visalia
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Yuba City
California · 31040
Office
Unavailable
Facility
$739.19
No comparable office rate is available.
Colorado
Colorado · 31040
Office
Unavailable
Facility
$737.92
No comparable office rate is available.
Connecticut
Connecticut · 31040
Office
Unavailable
Facility
$765.58
No comparable office rate is available.
Delaware
Delaware · 31040
Office
Unavailable
Facility
$714.29
No comparable office rate is available.
Fort Lauderdale
Florida · 31040
Office
Unavailable
Facility
$765.01
No comparable office rate is available.
Rest Of Florida
Florida · 31040
Office
Unavailable
Facility
$730.17
No comparable office rate is available.
Atlanta
Georgia · 31040
Office
Unavailable
Facility
$738.04
No comparable office rate is available.
Rest Of Georgia
Georgia · 31040
Office
Unavailable
Facility
$692.55
No comparable office rate is available.
Hawaii, Guam
Hawaii · 31040
Office
Unavailable
Facility
$750.42
No comparable office rate is available.
Iowa
Iowa · 31040
Office
Unavailable
Facility
$662.76
No comparable office rate is available.
Idaho
Idaho · 31040
Office
Unavailable
Facility
$668.16
No comparable office rate is available.
East St. Louis
Illinois · 31040
Office
Unavailable
Facility
$741.77
No comparable office rate is available.
Rest Of Illinois
Illinois · 31040
Office
Unavailable
Facility
$717.74
No comparable office rate is available.
Suburban Chicago
Illinois · 31040
Office
Unavailable
Facility
$770.50
No comparable office rate is available.
Indiana
Indiana · 31040
Office
Unavailable
Facility
$671.28
No comparable office rate is available.
Kansas
Kansas · 31040
Office
Unavailable
Facility
$663.95
No comparable office rate is available.
Kentucky
Kentucky · 31040
Office
Unavailable
Facility
$678.25
No comparable office rate is available.
New Orleans
Louisiana · 31040
Office
Unavailable
Facility
$707.30
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 31040
Office
Unavailable
Facility
$678.88
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 31040
Office
Unavailable
Facility
$798.60
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 31040
Office
Unavailable
Facility
$736.04
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 31040
Office
Unavailable
Facility
$764.17
No comparable office rate is available.
Rest Of Maryland
Maryland · 31040
Office
Unavailable
Facility
$725.33
No comparable office rate is available.
Rest Of Maine
Maine · 31040
Office
Unavailable
Facility
$675.28
No comparable office rate is available.
Southern Maine
Maine · 31040
Office
Unavailable
Facility
$700.97
No comparable office rate is available.
Detroit
Michigan · 31040
Office
Unavailable
Facility
$742.11
No comparable office rate is available.
Rest Of Michigan
Michigan · 31040
Office
Unavailable
Facility
$697.01
No comparable office rate is available.
Minnesota
Minnesota · 31040
Office
Unavailable
Facility
$698.48
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 31040
Office
Unavailable
Facility
$699.00
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 31040
Office
Unavailable
Facility
$704.81
No comparable office rate is available.
Rest Of Missouri
Missouri · 31040
Office
Unavailable
Facility
$671.46
No comparable office rate is available.
Mississippi
Mississippi · 31040
Office
Unavailable
Facility
$659.88
No comparable office rate is available.
Montana**
Montana · 31040
Office
Unavailable
Facility
$721.70
No comparable office rate is available.
North Carolina
North Carolina · 31040
Office
Unavailable
Facility
$680.72
No comparable office rate is available.
North Dakota**
North Dakota · 31040
Office
Unavailable
Facility
$693.42
No comparable office rate is available.
Nebraska
Nebraska · 31040
Office
Unavailable
Facility
$664.69
No comparable office rate is available.
New Hampshire
New Hampshire · 31040
Office
Unavailable
Facility
$730.41
No comparable office rate is available.
Northern Nj
New Jersey · 31040
Office
Unavailable
Facility
$802.01
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 31040
Office
Unavailable
Facility
$771.89
No comparable office rate is available.
New Mexico
New Mexico · 31040
Office
Unavailable
Facility
$701.87
No comparable office rate is available.
Nevada**
Nevada · 31040
Office
Unavailable
Facility
$714.17
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 31040
Office
Unavailable
Facility
$850.33
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 31040
Office
Unavailable
Facility
$779.94
No comparable office rate is available.
Queens
New York · 31040
Office
Unavailable
Facility
$828.02
No comparable office rate is available.
Rest Of New York
New York · 31040
Office
Unavailable
Facility
$689.82
No comparable office rate is available.
Ohio
Ohio · 31040
Office
Unavailable
Facility
$691.23
No comparable office rate is available.
Oklahoma
Oklahoma · 31040
Office
Unavailable
Facility
$673.08
No comparable office rate is available.
Portland
Oregon · 31040
Office
Unavailable
Facility
$754.14
No comparable office rate is available.
Rest Of Oregon
Oregon · 31040
Office
Unavailable
Facility
$706.18
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 31040
Office
Unavailable
Facility
$751.33
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 31040
Office
Unavailable
Facility
$690.00
No comparable office rate is available.
Puerto Rico
Puerto Rico · 31040
Office
Unavailable
Facility
$724.99
No comparable office rate is available.
Rhode Island
Rhode Island · 31040
Office
Unavailable
Facility
$734.42
No comparable office rate is available.
South Carolina
South Carolina · 31040
Office
Unavailable
Facility
$687.59
No comparable office rate is available.
South Dakota**
South Dakota · 31040
Office
Unavailable
Facility
$690.08
No comparable office rate is available.
Tennessee
Tennessee · 31040
Office
Unavailable
Facility
$667.31
No comparable office rate is available.
Austin
Texas · 31040
Office
Unavailable
Facility
$737.62
No comparable office rate is available.
Beaumont
Texas · 31040
Office
Unavailable
Facility
$686.39
No comparable office rate is available.
Brazoria
Texas · 31040
Office
Unavailable
Facility
$710.63
No comparable office rate is available.
Dallas
Texas · 31040
Office
Unavailable
Facility
$716.45
No comparable office rate is available.
Fort Worth
Texas · 31040
Office
Unavailable
Facility
$713.52
No comparable office rate is available.
Galveston
Texas · 31040
Office
Unavailable
Facility
$713.63
No comparable office rate is available.
Houston
Texas · 31040
Office
Unavailable
Facility
$739.81
No comparable office rate is available.
Rest Of Texas
Texas · 31040
Office
Unavailable
Facility
$699.02
No comparable office rate is available.
Utah
Utah · 31040
Office
Unavailable
Facility
$695.58
No comparable office rate is available.
Virginia
Virginia · 31040
Office
Unavailable
Facility
$701.70
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 31040
Office
Unavailable
Facility
$724.99
No comparable office rate is available.
Vermont
Vermont · 31040
Office
Unavailable
Facility
$694.64
No comparable office rate is available.
Rest Of Washington
Washington · 31040
Office
Unavailable
Facility
$733.37
No comparable office rate is available.
Seattle (King Cnty)
Washington · 31040
Office
Unavailable
Facility
$809.72
No comparable office rate is available.
Wisconsin
Wisconsin · 31040
Office
Unavailable
Facility
$673.80
No comparable office rate is available.
West Virginia
West Virginia · 31040
Office
Unavailable
Facility
$695.78
No comparable office rate is available.
See how rates vary across the country
31040 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 31040 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$780.31
$709.37 × 110% = $780.31
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 31040 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,499
- Code
- 31040
- Physician work
- 9.53
- Practice expense
- 10.65
- Malpractice
- 1.43
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.53 | × 1.000 | 9.5300 |
| Practice expense | 10.65 | × 1.000 | 10.6500 |
| Malpractice | 1.43 | × 0.740 | 1.0582 |
| Total RVUs | 21.2382 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$709.37
Open 31040 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.53 | 1 |
| Practice expense | 10.65 | 1 |
| Malpractice | 1.43 | 0.74 |
(9.53 × 1 + 10.65 × 1 + 1.43 × 0.74) × $33.4009 = $709.37
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
31040 · 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 | $709.37 | RVU26D |
| 2026-07-01 | Not available in this setting | $709.37 | RVU26C |
| 2026-04-01 | Not available in this setting | $709.37 | RVU26B |
| 2026-01-01 | Not available in this setting | $709.37 | RVU26A |
| 2025-10-01 | Not available in this setting | $768.83 | RVU25D |
| 2025-07-01 | Not available in this setting | $768.83 | RVU25C |
| 2025-04-01 | Not available in this setting | $768.83 | RVU25B |
| 2025-01-01 | Not available in this setting | $768.83 | RVU25A |
31040 billing questions
How does 31040 differ from maxillary sinus surgery?
31040 targets the pterygomaxillary fossa behind the upper jaw. Codes for maxillary sinus procedures target the sinus itself.
What documentation supports 31040?
The operative report should identify the pterygomaxillary fossa as the site explored and describe the surgical access and exploration.
Does the 90-day global period include related postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure reported?
Use modifier 50 for a bilateral procedure; CMS pays it at 150%.
Can an assistant or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only with supporting documentation.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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.
3,49631020,,Exploration maxillary sinus,A,,2.99,9.57,,6.43,,0.37,12.93,9.79,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49731030,,Exploration maxillary sinus,A,,5.86,12.89,,7.56,,0.78,19.53,14.20,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49831032,,Explore sinus remove polyps,A,,6.52,9.07,NA,9.07,,0.93,16.52,16.52,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49931040,,Exploration behind upper jaw,A,,9.53,10.65,NA,10.65,,1.43,21.61,21.61,0,090,0.10,0.76,0.14,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50031050,,Exploration sphenoid sinus,A,,5.24,8.26,NA,8.26,,0.78,14.28,14.28,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50131051,,Sphenoid sinus surgery,A,,7.07,10.90,NA,10.90,,1.05,19.02,19.02,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50231070,,Exploration of frontal sinus,A,,4.29,8.35,NA,8.35,,0.62,13.26,13.26,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,