No office rate
This code is for maxillary sinus irrigation; 31002 is for irrigation of the sphenoid sinus.
On this page
CMS RVU26D · Effective 2026-10-01
31000 Sinus irrigation Medicare reimbursement rates in Iowa
Reports lavage of a maxillary sinus to flush its contents, typically performed by an otolaryngologist during treatment of sinus disease. Compare 31000 office and facility rates across CMS payment localities in Iowa.
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 31000 in Iowa?
Iowa 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
$172.62
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$94.07
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
Otolaryngology
About 31000: Maxillary sinus irrigation
Reports lavage of a maxillary sinus to flush its contents, typically performed by an otolaryngologist during treatment of sinus disease.
The clinician accesses a maxillary sinus and flushes it with fluid to clear retained material. Otolaryngologists commonly perform the procedure in an office or procedure setting for a patient with maxillary sinus disease. The service is irrigation, not an operation to explore or surgically open the sinus. Record the treated sinus, laterality, reason for irrigation, access used, and the lavage performed.
Report the code when maxillary sinus irrigation is the service performed; distinguish it from irrigation of another sinus or a more extensive sinus operation. For bilateral treatment, modifier 50 is paid at 150%. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. The 10-day global period includes related postoperative visits during those 10 days. Medicare does not pay an assistant at surgery for this procedure; co-surgeons and team surgery are not permitted.
CMS billing rules for 31000
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.17 · 21%
- Practice expense (office) RVU4.30 · 76%
- Malpractice RVU0.16 · 3%
1.2K
Medicare services in 2024 · #2851 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.
31000 compared with similar codes
Office rates for Iowa, from the same CMS release.
$397.25
Use 31000 for maxillary sinus lavage. Code 31020 describes surgical exploration of the maxillary sinus.
$600.01
Use 31000 when the service is irrigation; 31030 describes a maxillary sinus exploration procedure.
Compare 31000 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
Iowa →
Office / nonfacility
$172.62
Facility
$94.07
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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 31000 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,493
- Code
- 31000
- Physician work
- 1.17
- Practice expense
- 4.30
- Malpractice
- 0.16
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.17 | × 1.000 | 1.1700 |
| Practice expense | 4.30 | × 0.915 | 3.9345 |
| Malpractice | 0.16 | × 0.397 | 0.0635 |
| Total RVUs | 5.1680 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$172.62
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 4.3 | 0.915 |
| Malpractice | 0.16 | 0.397 |
(1.17 × 1 + 4.3 × 0.915 + 0.16 × 0.397) × $33.4009 = $172.62
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 1.73 | 0.915 |
| Malpractice | 0.16 | 0.397 |
(1.17 × 1 + 1.73 × 0.915 + 0.16 × 0.397) × $33.4009 = $94.07
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.
31000 billing questions
How is maxillary irrigation distinguished from sphenoid irrigation?
Use this code for irrigation of a maxillary sinus. Code 31002 describes irrigation of the sphenoid sinus.
Is sinus exploration reported as irrigation?
No. This code describes flushing the maxillary sinus; codes 31020 and 31030 describe maxillary sinus exploration procedures.
What should the record show?
Document the maxillary sinus treated, laterality, clinical reason, access used, and that irrigation was performed.
How is bilateral treatment reported?
Report modifier 50 when both maxillary sinuses are treated. CMS pays the bilateral procedure at 150%.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this procedure, and 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.
3,4903095F,,Central dexa results docd,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4913096F,,Central dexa ordered,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49230999,,Unlisted procedure nose,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49331000,,Irrigation maxillary sinus,A,,1.17,4.30,,1.73,,0.16,5.63,3.06,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49431002,,Irrigation sphenoid sinus,A,,1.91,2.91,NA,2.91,,0.19,5.01,5.01,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,4953100F,,Image test ref carot diam,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49631020,,Exploration maxillary sinus,A,,2.99,9.57,,6.43,,0.37,12.93,9.79,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136