CPT code 31237: Nasal endoscopy2026 Medicare rate & RVUs in Florida
Report this surgical nasal or sinus endoscopy when the physician biopsies tissue, removes a polyp, or debrides postoperative material under endoscopic guidance.
Medicare pays $265.30–$292.38 for 31237 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 31237 covers
An otolaryngologist typically performs this procedure in an office, ambulatory surgery center, or hospital. Through a nasal endoscope, the physician obtains a biopsy, removes a polyp, or clears material such as crusts, clots, or devitalized tissue. Debridement may be performed during follow-up after endoscopic sinus surgery; the documented service must support actual endoscopic tissue treatment rather than inspection alone.
Select the code based on the work performed, and document the treated site and side, the tissue action, and any specimen sent for pathology. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral work, modifier 50 is paid at 150%. When related endoscopies are performed together, endoscopy-family pricing applies. An assistant at surgery is not paid under the statutory restriction; 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 31237 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.
3 payment localities
$265.30 to $292.38
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $278.73 | $148.80 |
| Miami | $292.38 | $158.86 |
| Rest Of Florida | $265.30 | $142.69 |
How the 31237 rate is calculated
Each of 31237’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 · 31237
RVUs × geographic indexes × conversion factor
Work2.54
2.54 RVUs× 1.000 GPCI
Practice expense5.07
5.07 RVUs× 1.000 GPCI
Malpractice0.37
0.37 RVUs× 1.000 GPCI
Adjusted RVUs
7.9800
Conversion factor
$33.4009
Medicare rate
$266.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31237
The CMS indicators that decide how 31237 is paid alongside other services.
CMS payment indicators · 31237
Nasal endoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
31237 without 50 · national office
$266.54
Nasal endoscopy
31237-50 · Bilateral: 150%
$399.81
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).
31237 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31231Nasal endoscopy
- This code includes biopsy, polypectomy, or debridement. Choose 31231 for diagnostic nasal endoscopy without those tissue-treatment services.
- 31238Nasal endoscopy
- 31238 is for endoscopic surgical control of nasal bleeding. Use 31237 for biopsy, polyp removal, or debridement rather than hemostasis as the primary work.
- 31254Ethmoidectomy
- 31254 describes endoscopic partial ethmoidectomy. It represents sinus surgery on the ethmoid, not the biopsy, polypectomy, or debridement service described by this code.
- 31267Sinus endoscopy
- 31267 describes endoscopic maxillary sinus surgery with tissue removal. Distinguish that sinus operation from a separately documented biopsy, polypectomy, or debridement service.
31237 billing questions
When is this code appropriate instead of diagnostic nasal endoscopy?
Use this code when endoscopy includes a biopsy, polypectomy, or debridement. Inspection and evaluation without one of those therapeutic or tissue-sampling services may support a diagnostic endoscopy code instead.
Can this code describe postoperative sinus debridement?
Yes, when the physician performs endoscopic debridement, such as clearing crusts, clots, or devitalized tissue. Document the treated area and the work performed.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure. Report modifier 50 for bilateral work; CMS payment is 150%.
What happens when related endoscopies are performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed together. The medical record should identify each procedure and its distinct purpose and site.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care. A debridement performed on a later date is not within that same-day global period.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery is not paid under the statutory restriction. CMS does not permit co-surgeons or team surgery for this procedure.
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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