Billing code 31200: EthmoidectomyMedicare rate & RVUs in Florida
Reports surgical removal of anterior ethmoid air cells through an intranasal approach, rather than endoscopic ethmoidectomy or a more extensive ethmoid removal.
CMS doesn’t publish an office rate for 31200 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 31200 covers
An otolaryngologist removes diseased tissue and air cells from the anterior ethmoid sinus through the nasal passage. The operation may be performed for ethmoid sinus disease when surgical treatment is needed; the code identifies the anterior portion and intranasal approach. It is distinct from endoscopic ethmoidectomy codes and from removal of the entire ethmoid sinus.
Report this code when the operative record supports an anterior intranasal ethmoidectomy, documenting the approach, extent, and side treated. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
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.
Where 31200 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $601.02 |
| Miami | Unavailable | $622.64 |
| Rest Of Florida | Unavailable | $573.70 |
How the 31200 rate is calculated
Each of 31200’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 31200
RVUs × geographic indexes × conversion factor
Work5.01
5.01 RVUs× 1.000 GPCI
Practice expense12.05
12.05 RVUs× 1.000 GPCI
Malpractice0.43
0.43 RVUs× 1.000 GPCI
Adjusted RVUs
17.4900
Conversion factor
$33.4009
Medicare rate
$584.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31200
31200 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31200
Ethmoidectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 31200
Ethmoidectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
31200 without 50 · national facility
$584.18
Ethmoidectomy
31200-50 · Bilateral: 150%
$876.27
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
31200 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31201Ethmoidectomy
- Both are intranasal ethmoidectomies; 31200 is limited to the anterior ethmoid, while 31201 represents total ethmoid removal.
- 31205Ethmoidectomy
- 31205 describes total ethmoid removal through an extranasal approach. Choose 31200 for the anterior intranasal operation.
- 31254Ethmoidectomy
- 31254 is for partial ethmoidectomy performed endoscopically. The approach, not just the limited extent, distinguishes it from 31200.
- 31255Ethmoidectomy
- 31255 reports total endoscopic ethmoidectomy; 31200 reports anterior ethmoid removal through an intranasal approach.
31200 billing questions
How does this differ from 31201?
31200 describes removal of the anterior ethmoid portion. 31201 is the related intranasal code for total ethmoid removal, so the documented extent determines the choice.
When would an endoscopic ethmoidectomy code be more appropriate?
Use an endoscopic ethmoidectomy code when the surgeon performs the ethmoid work endoscopically. Codes 31254 and 31255 distinguish partial from total endoscopic ethmoidectomy.
What documentation supports 31200?
The operative report should identify the intranasal approach, the anterior ethmoid work performed, and the side treated. Record the extent clearly enough to distinguish anterior removal from total ethmoidectomy.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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