$188.45
31000 is maxillary sinus irrigation. Choose 31020 when the surgeon creates or enlarges a surgical opening through the nasal cavity.
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CMS RVU26D · Effective 2026-10-01
31020 Maxillary sinusotomy Medicare reimbursement rates in Minnesota
Reports surgical opening of a maxillary sinus through the nasal cavity when treatment requires more than irrigation or a different surgical approach. Compare 31020 office and facility rates across CMS payment localities in Minnesota.
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 31020 in Minnesota?
Minnesota 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
$432.44
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$324.52
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
Sinus surgery
About 31020: Intranasal maxillary sinusotomy
Reports surgical opening of a maxillary sinus through the nasal cavity when treatment requires more than irrigation or a different surgical approach.
CPT 31020 represents surgical access to a maxillary sinus through the nasal cavity to open or enlarge its drainage pathway. An otolaryngologist typically performs the procedure for maxillary sinus disease requiring operative drainage or access, rather than a simple sinus rinse. The code identifies the intranasal approach; it is distinct from a Caldwell-Luc operation and from endoscopic maxillary procedures reported with endoscopy-specific codes.
Select the code when the operative report supports an intranasal maxillary sinusotomy. Document the side, approach, operative work, and relevant findings so the service can be distinguished from irrigation, a different approach, or removal of a polyp. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral surgery and is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 31020
- 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
- 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 RVU2.99 · 23%
- Practice expense (office) RVU9.57 · 74%
- Malpractice RVU0.37 · 3%
283
Medicare services in 2024 · #4035 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.
31020 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$646.46
Both address the maxillary sinus, but 31030 uses a Caldwell-Luc approach. Code 31020 describes the intranasal approach.
No office rate
31256 is for endoscopic maxillary antrostomy. Use 31020 for the intranasal sinusotomy when the documented procedure is not reported as an endoscopic antrostomy.
Compare 31020 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
Minnesota →
Office / nonfacility
$432.44
Facility
$324.52
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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 31020 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
3,496
- Code
- 31020
- Physician work
- 2.99
- Practice expense
- 9.57
- Malpractice
- 0.37
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.99 | × 1.000 | 2.9900 |
| Practice expense | 9.57 | × 1.029 | 9.8475 |
| Malpractice | 0.37 | × 0.296 | 0.1095 |
| Total RVUs | 12.9470 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$432.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.99 | 1 |
| Practice expense | 9.57 | 1.029 |
| Malpractice | 0.37 | 0.296 |
(2.99 × 1 + 9.57 × 1.029 + 0.37 × 0.296) × $33.4009 = $432.44
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.99 | 1 |
| Practice expense | 6.43 | 1.029 |
| Malpractice | 0.37 | 0.296 |
(2.99 × 1 + 6.43 × 1.029 + 0.37 × 0.296) × $33.4009 = $324.52
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.
31020 billing questions
How is 31020 different from 31030?
31020 describes access through the nasal cavity. 31030 is the maxillary sinus procedure performed through a Caldwell-Luc approach.
When should 31020 be used instead of 31000?
Use 31020 for surgical opening of the maxillary sinus. Code 31000 describes irrigation, not creation of a surgical opening.
How does 31020 differ from endoscopic maxillary antrostomy?
31020 identifies an intranasal sinusotomy. When the surgeon performs the maxillary antrostomy using nasal endoscopy, consider the endoscopic code that matches the work, such as 31256 or 31267 when tissue is removed.
How is bilateral 31020 reported?
For bilateral surgery, report modifier 50 under the CMS bilateral rule; payment is at 150%.
Can an assistant surgeon or co-surgeon be paid for 31020?
CMS restricts assistant-at-surgery payment for this code. 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.
3,49331000,,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
3,49731030,,Exploration maxillary sinus,A,,5.86,12.89,,7.56,,0.78,19.53,14.20,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49831032,,Explore sinus remove polyps,A,,6.52,9.07,NA,9.07,,0.93,16.52,16.52,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49931040,,Exploration behind upper jaw,A,,9.53,10.65,NA,10.65,,1.43,21.61,21.61,0,090,0.10,0.76,0.14,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002