FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

31070 Frontal sinus surgery Medicare reimbursement rates in Delaware

Reports surgical exploration of the frontal sinus to evaluate or treat frontal sinus disease, with the operative approach and work documented in the record. Compare 31070 office and facility rates across CMS payment localities in Delaware.

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 31070 in Delaware?

Delaware 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

$438.17

1 of 1 localities have a supported rate.

Payment area: Delaware

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.

Find 31070 in your payment locality →

Sinus surgery

About 31070: Frontal sinus surgical exploration

Reports surgical exploration of the frontal sinus to evaluate or treat frontal sinus disease, with the operative approach and work documented in the record.

A surgeon accesses the frontal sinus to inspect its cavity and may remove tissue as part of the exploration. This is distinct from simply irrigating a sinus or examining it with an endoscope through the nasal passage. The service is generally performed by an otolaryngologist in an operating room or other surgical setting for conditions requiring direct surgical access to the frontal sinus.

Report 31070 when the documented operation matches this frontal sinus exploration service; the operative report should identify the sinus, surgical access, findings, and any tissue removal. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral reporting, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

CMS billing rules for 31070

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 RVU4.29 · 32%
  • Practice expense (office) RVU8.35 · 63%
  • Malpractice RVU0.62 · 5%

31

Medicare services in 2024 · #5639 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.

31070 compared with similar codes

Office rates for Delaware, from the same CMS release.

31075

Frontal sinus exploration

No office rate

Both codes describe frontal sinus exploration. Check the full code descriptions against the documented approach and operative work; the short CMS descriptors are not enough to choose between them.

31276

Frontal sinus endoscopy

Tissue removal when performed

No office rate

31276 describes endoscopic frontal sinus surgery through the nasal passage. 31070 is for the separately defined surgical exploration service, not the endoscopic approach.

31020

Maxillary sinusotomy

Intranasal approach

$427.29

31020 concerns exploration of the maxillary sinus. 31070 concerns the frontal sinus, so the operated sinus determines which code is relevant.

Compare 31070 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

Office and facility base rates · shared scale starting at $0

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

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 31070 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

3,502

Code
31070
Physician work
4.29
Practice expense
8.35
Malpractice
0.62

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Facility calculation for 31070 in Delaware
ComponentRVULocality factorAdjusted
Physician work4.29× 1.0054.3114
Practice expense8.35× 0.9888.2498
Malpractice0.62× 0.8990.5574
Total RVUs13.1186
Conversion factor× 33.4009

Facility rate, Delaware$438.17

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.291.005
Practice expense8.350.988
Malpractice0.620.899

(4.29 × 1.005 + 8.35 × 0.988 + 0.62 × 0.899) × $33.4009 = $438.17

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.

31070 billing questions

How does 31070 differ from endoscopic frontal sinus surgery?

Use 31070 for the covered surgical exploration through direct surgical access. Endoscopic frontal sinus work performed through the nasal passage is represented by the appropriate endoscopic sinus code, such as 31276.

How should 31070 be distinguished from 31075?

Both codes concern frontal sinus exploration, so use the full code descriptions and the operative details to select the service that matches the documented approach and work. The short CMS labels alone do not establish the distinction.

What documentation supports reporting 31070?

The operative report should identify the frontal sinus, describe how it was accessed and explored, and record the findings and any tissue removal.

Can modifier 50 be used when both frontal sinuses are explored?

CMS lists this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%. The operative documentation should support work on both sides.

Can an assistant or co-surgeon be reported for 31070?

Medicare does not pay an assistant at surgery 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 31070PPRRVU2026_Oct_nonQPP.csv, line 3,502 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet