Billing code 31090: Sinus explorationMedicare rate & RVUs in Ohio
Reports operative exploration of paranasal sinus disease when the documented service is surgical exploration rather than irrigation or a more specifically defined sinus procedure.
CMS doesn’t publish an office rate for 31090 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 31090 covers
An otolaryngologist performs this operative service to explore sinus disease that requires surgical access, such as persistent or recurrent symptoms prompting assessment of the sinus cavity. The record should identify the clinical indication, sinus or sinuses explored, operative approach, findings, and work performed. This is distinct from flushing a sinus or simply examining the nasal passages with an endoscope.
Select the code when the documented operation matches sinus exploration and a more specific procedure code does not better describe the work. The CMS 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
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.
31090 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $960.08 |
How the 31090 rate is calculated
Each of 31090’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 31090
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.89Practice expense 17.80Malpractice 1.59
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31090
31090 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31090
Sinus exploration
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 31090
Sinus exploration
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
31090 without 50 · national facility
$1,011.38
Sinus exploration
31090-50 · Bilateral: 150%
$1,517.07
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
31090 compared with similar codes
Compare codes
31090 vs 31000 vs 31002 vs 31020 vs 31050: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31000Sinus irrigation
- 31000 describes irrigation of the maxillary sinus. Choose 31090 for documented operative exploration, not lavage alone.
- 31002Sinus irrigation
- 31002 describes irrigation of the sphenoid sinus. It does not represent operative exploration.
- 31020Maxillary sinusotomy
- 31020 is directed to the maxillary sinus. Use it when the operative report supports that specific procedure rather than general sinus exploration.
- 31050Sphenoid sinus surgery
- 31050 is directed to the sphenoid sinus. The operative report should support the sinus-specific procedure to select it over 31090.
31090 billing questions
How is sinus exploration different from sinus irrigation?
Exploration describes an operative service to access and assess sinus disease. Codes 31000 and 31002 describe irrigation of the maxillary and sphenoid sinuses, respectively.
When should a sinus-specific procedure code be considered instead?
Use a more specific code when the operative report documents a procedure directed to a particular sinus, such as maxillary, sphenoid, or frontal sinus surgery.
What documentation supports reporting 31090?
Document the indication, sinus or sinuses explored, approach, operative findings, and work performed so the service can be distinguished from irrigation or a specifically coded operation.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 be used for bilateral reporting?
CMS identifies this as a bilateral procedure; reporting with modifier 50 is paid at 150%.
Can an assistant or another surgeon be paid for this operation?
Assistant-at-surgery payment is subject to a statutory restriction. 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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