No office rate
31293 describes medial orbital wall decompression alone. Choose 31292 when the operative report also documents inferior orbital wall decompression.
On this page
CMS RVU26D · Effective 2026-10-01
31292 Orbital decompression Medicare reimbursement rates in Alabama
Endoscopic decompression of both the medial and inferior orbital walls, typically performed to relieve orbital pressure or proptosis. Compare 31292 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 31292 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$788.78
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Nasal and sinus surgery
About 31292: Endoscopic medial and inferior orbital decompression
Endoscopic decompression of both the medial and inferior orbital walls, typically performed to relieve orbital pressure or proptosis.
An otolaryngologist or rhinologist uses a transnasal endoscope to remove bone from the medial and inferior walls of the orbit, creating additional space for orbital contents. The procedure may be used for orbital pressure or proptosis, including in patients with thyroid eye disease, and is generally performed in an operating room. The operative report should identify the walls decompressed and the endoscopic work performed.
Report 31292 when the documented decompression includes both the medial and inferior orbital walls; medial-wall decompression alone is distinguished by 31293. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When related endoscopies are performed together, endoscopy-family pricing applies. For bilateral surgery, 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 31292
- 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 RVU15.50 · 61%
- Practice expense (office) RVU7.80 · 30%
- Malpractice RVU2.28 · 9%
87
Medicare services in 2024 · #4981 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.
31292 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
31294 is directed at optic nerve decompression. 31292 describes decompression of the medial and inferior orbital walls.
No office rate
31255 describes total ethmoid sinus surgery, not orbital wall decompression. Select based on the work documented and apply endoscopy-family pricing when related endoscopies are performed together.
Compare 31292 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$788.78
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 31292 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
3,547
- Code
- 31292
- Physician work
- 15.50
- Practice expense
- 7.80
- Malpractice
- 2.28
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.50 | × 1.000 | 15.5000 |
| Practice expense | 7.80 | × 0.875 | 6.8250 |
| Malpractice | 2.28 | × 0.566 | 1.2905 |
| Total RVUs | 23.6155 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$788.78
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.5 | 1 |
| Practice expense | 7.8 | 0.875 |
| Malpractice | 2.28 | 0.566 |
(15.5 × 1 + 7.8 × 0.875 + 2.28 × 0.566) × $33.4009 = $788.78
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.
31292 billing questions
Is an optic nerve decompression reported with 31292?
31292 describes medial and inferior orbital wall decompression. A procedure directed at the optic nerve is represented by 31294, so select according to the operative target and work.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in 31292.
How is bilateral decompression reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
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 under the CMS rules for this code.
What if other nasal or sinus endoscopies are performed in the same session?
Document the distinct procedures performed. CMS applies endoscopy-family pricing when related endoscopies are performed together.
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.
3,54431288,,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
3,54931294,,Nsl/sins ndsc surg on dcmprn,A,,19.80,8.80,NA,8.80,,2.90,31.50,31.50,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,55031295,,Nsl/sins ndsc surg max sins,A,,2.63,44.21,,1.02,,0.39,47.23,4.04,0,000,0.00,0.00,0.00,3,1,2,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515