No office rate
Choose 68720 for DCR using an external approach. This code represents the endoscopic nasal approach to creating the tear-drainage opening.
On this page
CMS RVU26D · Effective 2026-10-01
31239 Endoscopic DCR Medicare reimbursement rates in Nebraska
Reports endonasal surgery that creates a drainage pathway from the lacrimal sac into the nose to treat nasolacrimal obstruction. Compare 31239 office and facility rates across CMS payment localities in Nebraska.
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 31239 in Nebraska?
Nebraska 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
No supported rate
Facility setting
$488.96
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Nasal surgery
About 31239: Endoscopic tear duct bypass surgery
Reports endonasal surgery that creates a drainage pathway from the lacrimal sac into the nose to treat nasolacrimal obstruction.
An endoscopic dacryocystorhinostomy creates a route for tears to drain from the lacrimal sac into the nasal cavity, bypassing an obstructed nasolacrimal duct. An otolaryngologist typically performs the operation through the nose, often in a facility operating room; an ophthalmologist may participate in care of the tear-drainage system. The operative report should establish that the surgeon created the nasal opening for lacrimal drainage, rather than only examining the nose or probing the duct.
Report the code for the endoscopic DCR and document the operative approach, treated side, and any other nasal or sinus procedures performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When related endoscopic procedures are performed together, CMS endoscopy-family pricing applies. For bilateral surgery, modifier 50 is paid at 150%. An assistant at surgery is payable only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 31239
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.81 · 56%
- Practice expense (office) RVU5.91 · 38%
- Malpractice RVU0.99 · 6%
1.8K
Medicare services in 2024 · #2550 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.
31239 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$347.30
Choose 68815 when the service is duct probing with insertion of a tube or stent. Report this code when the surgeon creates an endoscopic opening from the lacrimal sac into the nose.
$178.34
31231 is for diagnostic nasal endoscopy. It does not represent the operative DCR that establishes a new drainage route.
$239.93
31238 addresses endoscopic surgical control of nasal bleeding. This code is for endoscopic tear-drainage surgery, not treatment of epistaxis.
Compare 31239 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$488.96
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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 31239 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
3,529
- Code
- 31239
- Physician work
- 8.81
- Practice expense
- 5.91
- Malpractice
- 0.99
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.81 | × 1.000 | 8.8100 |
| Practice expense | 5.91 | × 0.923 | 5.4549 |
| Malpractice | 0.99 | × 0.378 | 0.3742 |
| Total RVUs | 14.6391 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$488.96
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.81 | 1 |
| Practice expense | 5.91 | 0.923 |
| Malpractice | 0.99 | 0.378 |
(8.81 × 1 + 5.91 × 0.923 + 0.99 × 0.378) × $33.4009 = $488.96
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.
31239 billing questions
How does this differ from external DCR?
This code represents creation of the tear-drainage opening through a nasal endoscopic approach. Code 68720 describes DCR performed by an external approach.
Is this appropriate for duct probing with a stent?
Use 68815 for nasolacrimal duct probing with insertion of a tube or stent when that is the service performed. This code is for endoscopic creation of a drainage opening from the lacrimal sac into the nose.
Can diagnostic nasal endoscopy also be reported?
A diagnostic nasal examination alone is represented by 31231. The operative report should support the DCR rather than a separately performed diagnostic examination.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure; report modifier 50 for bilateral surgery. CMS pays the bilateral service at 150%.
When is an assistant payable?
CMS pays an assistant at surgery only when the record documents medical necessity. 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.
3,52631235,,Nsl/sins ndsc dx sphn sinusc,A,,2.57,6.35,,1.19,,0.37,9.29,4.13,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,52731237,,Nsl/sins ndsc surg bx polypc,A,,2.54,5.07,,1.23,,0.37,7.98,4.14,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,52831238,,Nsl/sins ndsc srg nsl hemrrg,A,,2.67,4.73,,1.26,,0.39,7.79,4.32,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,52931239,,Nsl/sinus endoscopy surg dcr,A,,8.81,5.91,NA,5.91,,0.99,15.71,15.71,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53031240,,Nsl/sns ndsc cnch bull rescj,A,,2.54,1.18,NA,1.18,,0.37,4.09,4.09,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53131241,,Nsl/sns ndsc lig sphnptn art,A,,7.80,2.23,NA,2.23,,1.14,11.17,11.17,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53231242,,Nsl/sinus ndsc rf abltj pnn,A,,2.63,68.70,,1.02,,0.39,71.72,4.04,0,000,0.00,0.00,0.00,3,2,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068