$179.28–$222.27
Both codes describe sinus irrigation, but 31000 is for the maxillary sinus; 31002 is for the sphenoid sinus.
On this page
CMS RVU26D · Effective 2026-10-01
31002 Sinus irrigation Medicare reimbursement rates in New York
Reports lavage of the sphenoid sinus, typically by an otolaryngologist treating retained secretions or inflammatory material in that sinus. Compare 31002 office and facility rates across CMS payment localities in New York.
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 31002 in New York?
New York has 5 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 5 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$160.59–$195.23
5 of 5 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.
Where 31002 pays more and less in New York
Sinus procedure
About 31002: Sphenoid sinus irrigation
Reports lavage of the sphenoid sinus, typically by an otolaryngologist treating retained secretions or inflammatory material in that sinus.
This service involves introducing irrigation fluid into the sphenoid sinus and flushing or clearing its contents. Otolaryngologists typically perform it for a patient with sphenoid sinus disease and retained secretions, often in an office or outpatient setting. The record should identify the sphenoid sinus treated and describe the irrigation performed; symptoms or a diagnosis alone do not establish that lavage occurred.
Report the code for the sphenoid sinus irrigation itself, rather than for operative exploration or creation of a sinus opening. If both sphenoid sinuses are treated, CMS recognizes bilateral reporting with modifier 50, paid at 150%. The service has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 31002
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 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 RVU1.91 · 38%
- Practice expense (office) RVU2.91 · 58%
- Malpractice RVU0.19 · 4%
304
Medicare services in 2024 · #3985 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.
31002 compared with similar codes
Office rates for New York, from the same CMS release.
No office rate
31002 reports sphenoid sinus irrigation. Choose 31050 when the documented service is sphenoid sinus exploration.
No office rate
31287 describes endoscopic sphenoidotomy, not irrigation. Select it when the operative service is creation or enlargement of the sphenoid opening.
No office rate
31288 is the endoscopic sphenoidotomy code when tissue is removed from the sinus; 31002 reports irrigation.
Compare 31002 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.
5 of 5 payment localities
Manhattan →
Office / nonfacility
Unavailable
Facility
$190.89
Nyc Suburbs/Long Island →
Office / nonfacility
Unavailable
Facility
$195.23
Poughkpsie/N Nyc Suburbs →
Office / nonfacility
Unavailable
Facility
$180.78
Queens →
Office / nonfacility
Unavailable
Facility
$191.92
Rest Of New York →
Office / nonfacility
Unavailable
Facility
$160.59
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31002 billing questions
How is sphenoid irrigation different from sphenoid exploration?
Use this code when the documented service is irrigation of the sphenoid sinus. Exploration is a different operative service and should be selected when exploration, rather than lavage, was performed.
Can modifier 50 be reported when both sphenoid sinuses are irrigated?
Yes. CMS identifies the procedure as bilateral with modifier 50, paid at 150%; document that irrigation was performed on both sides.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
How does the multiple-procedure reduction work?
When procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
What documentation supports reporting this code?
Document the sphenoid sinus treated and the irrigation performed. A diagnosis of sinusitis without documentation of lavage does not describe this service.
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.
3,4913096F,,Central dexa ordered,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
3,49230999,,Unlisted procedure nose,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
3,49331000,,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