$469.59–$491.08
Choose 31254 for partial ethmoidectomy. This code represents treatment of both anterior and posterior ethmoid cells.
On this page
CMS RVU26D · Effective 2026-10-01
31255 Ethmoidectomy Medicare reimbursement rates in New Jersey
Endoscopic total ethmoidectomy removes disease from both anterior and posterior ethmoid air cells during operative treatment of ethmoid sinus disease. Compare 31255 office and facility rates across CMS payment localities in New Jersey.
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 31255 in New Jersey?
New Jersey 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
$288.75–$296.24
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.
Otolaryngology surgery
About 31255: Endoscopic total ethmoidectomy
Endoscopic total ethmoidectomy removes disease from both anterior and posterior ethmoid air cells during operative treatment of ethmoid sinus disease.
An otolaryngologist uses a nasal endoscope to operate on the ethmoid sinuses, removing the anterior and posterior ethmoid air cells. This procedure may be performed for chronic ethmoid sinus disease, including disease associated with nasal polyps, in a hospital or ambulatory surgical setting. The operative report should identify the side treated and document the extent of ethmoid dissection.
Report this code when the surgeon performs a total ethmoidectomy, rather than a partial ethmoidectomy. If the operation also includes frontal sinus exploration or sphenoid sinus surgery, select the applicable combined endoscopy code when its service is performed. CMS applies endoscopy family pricing when related endoscopies are performed together. For bilateral surgery, modifier 50 is paid at 150%. The 0-day global period includes same-day preoperative and postoperative care. CMS does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 31255
- 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
- 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 RVU5.61 · 69%
- Practice expense (office) RVU1.75 · 21%
- Malpractice RVU0.82 · 10%
6.8K
Medicare services in 2024 · #1680 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.
31255 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
Choose 31253 when total ethmoidectomy is performed with frontal sinus exploration; use 31255 for total ethmoidectomy without that combination.
No office rate
Choose 31257 when total ethmoidectomy is combined with sphenoidotomy. This code covers the total ethmoidectomy alone.
No office rate
Choose 31259 when total ethmoidectomy is combined with sphenoidotomy and sphenoid tissue removal. This code does not describe that combined sphenoid service.
Compare 31255 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$296.24
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$288.75
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31255 billing questions
How do I distinguish this from 31254?
Use 31255 for a total ethmoidectomy involving anterior and posterior ethmoid cells. Code 31254 describes a partial ethmoidectomy.
What if frontal or sphenoid sinus surgery is also performed?
Check whether a combined code describes the total ethmoidectomy and the additional sinus work. Codes 31253, 31257, and 31259 cover specified combinations with frontal or sphenoid procedures.
What documentation supports reporting 31255?
The operative report should establish that the surgeon treated both anterior and posterior ethmoid cells and identify the side or sides operated on.
How is bilateral surgery handled under the CMS rules?
Report modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery 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.
3,53331243,,Nsl/sinus ndsc cryoabltj pnn,A,,2.63,66.62,,1.02,,0.39,69.64,4.04,0,000,0.00,0.00,0.00,3,2,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53431253,,Nsl/sins ndsc total,A,,8.78,2.51,NA,2.51,,1.29,12.58,12.58,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53531254,,Nsl/sins ndsc w/prtl ethmdct,A,,4.16,8.31,,1.40,,0.60,13.07,6.16,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53631255,,Nsl/sins ndsc w/tot ethmdct,A,,5.61,1.75,NA,1.75,,0.82,8.18,8.18,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53731256,,Exploration maxillary sinus,A,,3.03,1.11,NA,1.11,,0.43,4.57,4.57,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53831257,,Nsl/sins ndsc tot w/sphendt,A,,7.80,2.29,NA,2.29,,1.14,11.23,11.23,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,53931259,,Nsl/sins ndsc sphn tiss rmvl,A,,8.27,2.40,NA,2.40,,1.22,11.89,11.89,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00