Billing code 31086: Frontal sinus surgeryMedicare rate & RVUs in Georgia
Frontal sinus removal surgery is reported when an operative procedure removes frontal sinus tissue rather than merely exploring or irrigating the sinus.
CMS doesn’t publish an office rate for 31086 in Georgia.
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 31086 covers
Code 31086 represents an operative removal procedure involving the frontal sinus, the air cavity above the eyes that drains into the nasal passages. It is distinct from a procedure limited to examining or opening the sinus. Otolaryngologists and surgeons who manage complex frontal sinus disease may perform this work in an operating room for conditions such as persistent inflammatory disease, a mucocele, or a lesion requiring surgical removal. The operative report should identify the frontal sinus as the treated site and describe the tissue removed and the operative extent.
Report 31086 when the documented operation matches this frontal sinus removal variant, not solely because the diagnosis involves frontal sinus disease. Record the approach, anatomic extent, and concurrent procedures; use the applicable sibling code when the operative details fit another variant. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 31086 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $1,079.96 |
| Rest Of Georgia | Unavailable | $1,013.42 |
How the 31086 rate is calculated
Each of 31086’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 · 31086
RVUs × geographic indexes × conversion factor
Work14.00
14.00 RVUs× 1.000 GPCI
Practice expense15.58
15.58 RVUs× 1.000 GPCI
Malpractice2.05
2.05 RVUs× 1.000 GPCI
Adjusted RVUs
31.6300
Conversion factor
$33.4009
Medicare rate
$1,056.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31086
31086 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31086
Frontal sinus surgery
| 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) | 2 | Paid. |
| 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 · 31086
Frontal sinus surgery
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
31086 without 50 · national facility
$1,056.47
Frontal sinus surgery
31086-50 · Bilateral: 150%
$1,584.71
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).
31086 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31070Frontal sinus surgery
- 31070 describes frontal sinus exploration. Use 31086 when the operation is the frontal sinus removal variant, rather than exploration alone.
- 31075Frontal sinus exploration
- 31075 is also a frontal sinus exploration code. The operative report should support removal work for 31086 rather than exploration alone.
- 31084Frontal sinus surgery
- 31084 is a sibling frontal sinus removal code. Distinguish it from 31086 by matching the documented operative technique and extent to the applicable billing code variant.
31086 billing questions
How is 31086 different from a frontal sinus exploration code?
31086 represents a removal procedure. Codes 31070 and 31075 describe frontal sinus exploration; use an exploration code when the documented work is limited to exploration rather than the removal procedure represented by 31086.
What should the operative report document?
Document the frontal sinus as the operative site, the approach and extent of the procedure, and the tissue removed. Those details help distinguish 31086 from exploration and from other frontal sinus removal variants.
How does modifier 50 affect payment?
CMS identifies this as a bilateral procedure: reporting modifier 50 results in payment at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be made. CMS does not permit co-surgeons or team surgery for this code.
How is 31086 affected when other procedures are performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures 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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