No office rate
Both concern frontal sinus surgery, but the specific procedure and method documented in the operative report determine which code applies.
On this page
CMS RVU26D · Effective 2026-10-01
31085 Frontal sinus surgery Medicare reimbursement rates in Michigan
Reports a surgical frontal sinus procedure involving removal, selected from the operative technique and extent documented by the surgeon. Compare 31085 office and facility rates across CMS payment localities in Michigan.
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 31085 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1077.27–$1145.98
2 of 2 localities have a supported rate.
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.
Sinus surgery
About 31085: Frontal sinus surgery with removal
Reports a surgical frontal sinus procedure involving removal, selected from the operative technique and extent documented by the surgeon.
This code is for surgical work on the frontal sinus in which removal is part of the procedure. Otolaryngologists typically perform frontal sinus surgery in an operating room, often for disease that requires operative treatment rather than office irrigation or diagnostic exploration. The operative report should identify the frontal sinus treated, the surgical approach, what was removed, and whether the sinus was left open or obliterated. Those details help distinguish this code from other frontal sinus procedures.
Choose among the neighboring frontal sinus codes according to the actual technique and extent documented, not simply the diagnosis or the phrase “frontal sinus removal.” This is major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. If multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 31085
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.25 · 46%
- Practice expense (office) RVU15.89 · 48%
- Malpractice RVU2.21 · 7%
63
Medicare services in 2024 · #5210 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.
31085 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
This neighboring code describes an obliterative frontal sinus procedure without an osteoplastic flap; select based on the procedure actually performed.
No office rate
This neighboring code describes an obliterative frontal sinus procedure using an osteoplastic flap; the operative technique is the key distinction.
Compare 31085 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$1145.98
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$1077.27
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31085 billing questions
How should this code be distinguished from other frontal sinus surgery codes?
Use the operative report to identify the specific approach, extent of removal, and whether the sinus was obliterated. The diagnosis alone does not establish which frontal sinus code applies.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and related postoperative care for 90 days.
How are multiple procedures handled in the same session?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction and paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, while team-surgery payment is not permitted.
How is bilateral surgery reported?
For a bilateral procedure, modifier 50 is paid at 150%.
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.
3,50431080,,Removal of frontal sinus,A,,12.42,15.20,NA,15.20,,1.80,29.42,29.42,0,090,0.10,0.76,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50531081,,Removal of frontal sinus,A,,13.84,15.54,NA,15.54,,2.02,31.40,31.40,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50631084,,Removal of frontal sinus,A,,14.58,15.72,NA,15.72,,2.13,32.43,32.43,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50731085,,Removal of frontal sinus,A,,15.25,15.89,NA,15.89,,2.21,33.35,33.35,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50831086,,Removal of frontal sinus,A,,14.00,15.58,NA,15.58,,2.05,31.63,31.63,0,090,0.10,0.76,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50931087,,Removal of frontal sinus,A,,14.21,13.68,NA,13.68,,2.07,29.96,29.96,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,51031090,,Exploration of sinuses,A,,10.89,17.80,NA,17.80,,1.59,30.28,30.28,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00