Billing code 31030: Sinus explorationMedicare rate & RVUs in Georgia
Intranasal exploration of the maxillary sinus is reported when an otolaryngologist surgically enters and examines that sinus rather than irrigating it.
Medicare pays $610.82–$665.03 for 31030 in the office in Georgia, from Rest Of Georgia to Atlanta. 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 31030 covers
An otolaryngologist uses an intranasal surgical approach to enter and examine the maxillary sinus, such as when evaluating disease or a suspected abnormality within the sinus. This is an operative exploration, not simply office-based nasal examination or lavage. The operative note should identify the maxillary sinus treated, the intranasal approach, and the findings or purpose of the exploration.
Report this code for the documented intranasal exploration; use a different code when the service is irrigation, a Caldwell-Luc approach, or endoscopic antrostomy. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 31030 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $665.03 | $484.16 |
| Rest Of Georgia | $610.82 | $452.02 |
How the 31030 rate is calculated
Each of 31030’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 · 31030
RVUs × geographic indexes × conversion factor
Work5.86
5.86 RVUs× 1.000 GPCI
Practice expense12.89
12.89 RVUs× 1.000 GPCI
Malpractice0.78
0.78 RVUs× 1.000 GPCI
Adjusted RVUs
19.5300
Conversion factor
$33.4009
Medicare rate
$652.32
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31030
31030 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31030
Sinus exploration
| 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 · 31030
Sinus exploration
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
31030 without 50 · national office
$652.32
Sinus exploration
31030-50 · Bilateral: 150%
$978.48
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).
31030 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31020Maxillary sinusotomy
- Choose 31030 for intranasal maxillary sinus exploration; 31020 describes maxillary sinusotomy through the Caldwell-Luc approach.
- 31000Sinus irrigation
- 31000 is maxillary sinus irrigation by lavage. It does not describe operative exploration of the sinus.
- 31256Maxillary antrostomy
- 31256 describes endoscopic maxillary antrostomy. Distinguish it from 31030 by the documented procedure and approach.
31030 billing questions
How is this different from 31020?
31030 describes intranasal exploration of the maxillary sinus. Code 31020 is for a maxillary sinusotomy using the Caldwell-Luc approach.
Can maxillary sinus irrigation be reported instead?
No. Code 31000 describes maxillary sinus irrigation; use 31030 when the documented service is surgical intranasal exploration rather than lavage.
What documentation supports 31030?
Document the maxillary sinus explored, the intranasal surgical approach, and the operative findings or reason for exploration.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How are bilateral and same-session procedures handled?
Bilateral performance with 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 are paid at 50%.
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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