$191.20
31231 is for diagnostic nasal endoscopy. Use 31240 when the surgeon actually resects a concha bullosa.
On this page
CMS RVU26D · Effective 2026-10-01
31240 Concha resection Medicare reimbursement rates in Delaware
Reports endoscopic resection of a pneumatized middle turbinate when it obstructs nasal airflow or limits access to the middle meatus or sinuses. Compare 31240 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 31240 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
$135.31
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.
Nasal and sinus surgery
About 31240: Endoscopic concha bullosa resection
Reports endoscopic resection of a pneumatized middle turbinate when it obstructs nasal airflow or limits access to the middle meatus or sinuses.
An otolaryngologist uses a nasal endoscope to resect a concha bullosa, an air-filled expansion of the middle turbinate. This may be performed for nasal obstruction or when the enlarged turbinate narrows the middle meatus and interferes with access during sinus surgery. The service is typically performed in an operating room or ambulatory surgery setting.
The operative note should identify the affected side, the concha bullosa and its clinical effect, and the endoscopic resection performed. For bilateral work, CMS pays this procedure with modifier 50 at 150%. It 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. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 31240
- 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
- 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 RVU2.54 · 62%
- Practice expense (office) RVU1.18 · 29%
- Malpractice RVU0.37 · 9%
4.6K
Medicare services in 2024 · #1928 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.
31240 compared with similar codes
Office rates for Delaware, from the same CMS release.
$263.68
31237 concerns endoscopic biopsy or removal of nasal or sinus tissue such as a polyp; 31240 is specific to resection of a concha bullosa.
$431.89
31254 reports partial ethmoid sinus surgery. It does not identify resection of a concha bullosa, which is reported with 31240 when performed.
Compare 31240 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
Delaware →
Office / nonfacility
Unavailable
Facility
$135.31
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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 31240 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
3,530
- Code
- 31240
- Physician work
- 2.54
- Practice expense
- 1.18
- Malpractice
- 0.37
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.54 | × 1.005 | 2.5527 |
| Practice expense | 1.18 | × 0.988 | 1.1658 |
| Malpractice | 0.37 | × 0.899 | 0.3326 |
| Total RVUs | 4.0512 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$135.31
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.54 | 1.005 |
| Practice expense | 1.18 | 0.988 |
| Malpractice | 0.37 | 0.899 |
(2.54 × 1.005 + 1.18 × 0.988 + 0.37 × 0.899) × $33.4009 = $135.31
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.
31240 billing questions
How is 31240 different from diagnostic nasal endoscopy?
31240 reports surgical resection of a concha bullosa, not inspection alone. Diagnostic nasal endoscopy is used when the service is an examination without this resection.
What documentation supports reporting 31240?
Document the concha bullosa, the side treated, its effect on airflow or surgical access, and the endoscopic resection performed.
Can 31240 be reported with other sinus endoscopies?
It may be performed with related sinus endoscopic procedures. CMS endoscopy-family pricing applies when related endoscopies are performed together.
How is bilateral resection reported?
Report bilateral work with modifier 50. CMS pays the bilateral procedure at 150%.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when the record documents medical necessity. 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.
3,52731237,,Nsl/sins ndsc surg bx polypc,A,,2.54,5.07,,1.23,,0.37,7.98,4.14,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,52831238,,Nsl/sins ndsc srg nsl hemrrg,A,,2.67,4.73,,1.26,,0.39,7.79,4.32,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,52931239,,Nsl/sinus endoscopy surg dcr,A,,8.81,5.91,NA,5.91,,0.99,15.71,15.71,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53031240,,Nsl/sns ndsc cnch bull rescj,A,,2.54,1.18,NA,1.18,,0.37,4.09,4.09,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53131241,,Nsl/sns ndsc lig sphnptn art,A,,7.80,2.23,NA,2.23,,1.14,11.17,11.17,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53231242,,Nsl/sinus ndsc rf abltj pnn,A,,2.63,68.70,,1.02,,0.39,71.72,4.04,0,000,0.00,0.00,0.00,3,2,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53331243,,Nsl/sinus ndsc cryoabltj pnn,A,,2.63,66.62,,1.02,,0.39,69.64,4.04,0,000,0.00,0.00,0.00,3,2,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503