$1,479.73
31296 describes dilation of the frontal sinus opening alone. Choose 31298 when the sphenoid opening is also dilated in the session.
On this page
CMS RVU26D · Effective 2026-10-01
31298 Sinus dilation Medicare reimbursement rates in Nebraska
Endoscopic dilation of frontal and sphenoid sinus openings is reported when both drainage pathways are treated during the same operative session. Compare 31298 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 31298 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
$2737.31
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$199.16
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/sinus endoscopy
About 31298: Frontal and sphenoid sinus dilation
Endoscopic dilation of frontal and sphenoid sinus openings is reported when both drainage pathways are treated during the same operative session.
An otolaryngologist uses a nasal endoscope to access and enlarge the frontal and sphenoid sinus openings, commonly with a balloon catheter passed through the nasal cavity. The procedure may be performed for obstructed sinus drainage, including in patients with chronic rhinosinusitis, when the operative plan is dilation at both sites. It is typically performed in an operating or procedural setting; the record should identify each sinus treated and the dilation performed.
Report 31298 when both frontal and sphenoid openings are dilated during the operative session; single-sinus dilation codes distinguish treatment of only one site. Document the treated anatomy, laterality, and technique. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Related endoscopies performed together are subject to endoscopy-family pricing. For bilateral work, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 31298
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU4.39 · 5%
- Practice expense (office) RVU83.78 · 94%
- Malpractice RVU0.62 · 1%
9.3K
Medicare services in 2024 · #1508 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.
31298 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$1,443.60
31297 describes dilation of the sphenoid sinus opening alone. Choose 31298 when the frontal opening is also dilated in the session.
No office rate
31276 is frontal sinus endoscopic surgery involving tissue removal; 31298 describes dilation of the frontal and sphenoid openings.
No office rate
31287 is endoscopic sphenoid sinus surgery without tissue removal, not dilation of both the sphenoid and frontal openings.
Compare 31298 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
$2737.31
Facility
$199.16
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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 31298 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
3,553
- Code
- 31298
- Physician work
- 4.39
- Practice expense
- 83.78
- Malpractice
- 0.62
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.39 | × 1.000 | 4.3900 |
| Practice expense | 83.78 | × 0.923 | 77.3289 |
| Malpractice | 0.62 | × 0.378 | 0.2344 |
| Total RVUs | 81.9533 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$2737.31
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.39 | 1 |
| Practice expense | 83.78 | 0.923 |
| Malpractice | 0.62 | 0.378 |
(4.39 × 1 + 83.78 × 0.923 + 0.62 × 0.378) × $33.4009 = $2737.31
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.39 | 1 |
| Practice expense | 1.45 | 0.923 |
| Malpractice | 0.62 | 0.378 |
(4.39 × 1 + 1.45 × 0.923 + 0.62 × 0.378) × $33.4009 = $199.16
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.
31298 billing questions
When should I choose 31298 over 31296 or 31297?
Use 31298 when the frontal and sphenoid sinus openings are both dilated. Codes 31296 and 31297 describe dilation at the frontal and sphenoid sites, respectively, when only one of those sites is treated.
Does 31298 include maxillary sinus dilation?
No. This code identifies dilation of the frontal and sphenoid openings. The maxillary sinus dilation code is 31295.
How should I report bilateral dilation?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The operative documentation should support treatment on both sides.
How does payment work when related endoscopies are performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed together. The same-day preoperative and postoperative care is included in the 0-day global period.
What documentation supports reporting 31298?
Document endoscopic dilation of both the frontal and sphenoid sinus openings, along with the treated side or sides and the technique performed. Assistant-at-surgery payment requires documentation of medical necessity.
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.
3,55031295,,Nsl/sins ndsc surg max sins,A,,2.63,44.21,,1.02,,0.39,47.23,4.04,0,000,0.00,0.00,0.00,3,1,2,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,55131296,,Nsl/sins ndsc surg frnt sins,A,,3.02,44.55,,1.11,,0.43,48.00,4.56,0,000,0.00,0.00,0.00,3,1,2,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,55231297,,Nsl/sins ndsc surg sphn sins,A,,2.38,44.10,,0.96,,0.36,46.84,3.70,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,55331298,,Nsl/sins ndsc surg frnt&sphn,A,,4.39,83.78,,1.45,,0.62,88.79,6.46,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,55431299,,Unlisted px accessory sinus,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
3,55531300,,Removal of larynx lesion,A,,15.51,15.81,NA,15.81,,2.26,33.58,33.58,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,5563130F,,Upper gi endoscopy performed,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
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