Billing code 31205: EthmoidectomyMedicare rate & RVUs in Ohio
Reports surgical removal of anterior ethmoid cells through an intranasal approach for disease requiring ethmoid surgery, rather than an extranasal or endoscopic procedure.
CMS doesn’t publish an office rate for 31205 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 31205 covers
This procedure removes diseased anterior ethmoid air cells through the nasal cavity using a nonendoscopic intranasal approach. Otolaryngologists typically perform it in an operating room for ethmoid sinus disease requiring surgical treatment. The operative report should make clear that the approach was intranasal and identify the anterior ethmoid work performed; endoscopic ethmoidectomy and extranasal ethmoidectomy are distinct approaches with separate codes.
Report the code when the documented operation matches this approach and extent, not based on the diagnosis alone. It has a 90-day global period, which 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 other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be available; co-surgeons are paid only with supporting documentation, and team surgery is 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.
31205 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $800.77 |
How the 31205 rate is calculated
Each of 31205’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 · 31205
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.32Practice expense 13.94Malpractice 0.92
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31205
31205 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31205
Ethmoidectomy
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 31205
Ethmoidectomy
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
31205 without 50 · national facility
$841.03
Ethmoidectomy
31205-50 · Bilateral: 150%
$1,261.55
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).
31205 compared with similar codes
Compare codes
31205 vs 31200 vs 31201 vs 31254 vs 31255: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31200Ethmoidectomy
- 31200 describes partial ethmoidectomy through an extranasal approach. This code describes an intranasal anterior ethmoid procedure.
- 31201Ethmoidectomy
- 31201 describes total ethmoidectomy through an extranasal approach. Choose this code when the documented work is intranasal and anterior.
- 31254Ethmoidectomy
- 31254 is an endoscopic partial ethmoidectomy. This code applies to an intranasal procedure performed without the endoscopic approach.
- 31255Ethmoidectomy
- 31255 is an endoscopic total ethmoidectomy. This code applies to the intranasal anterior ethmoid procedure, not endoscopic total removal.
31205 billing questions
How does this differ from endoscopic ethmoidectomy?
This code is for an intranasal, nonendoscopic anterior ethmoid procedure. Endoscopic ethmoidectomy codes apply when the surgeon performs the work using a nasal endoscope.
How do I distinguish it from codes 31200 and 31201?
Those codes describe extranasal ethmoidectomy. Use this code for the intranasal anterior approach documented in the operative report.
What documentation supports reporting this code?
The operative report should identify the intranasal approach and the anterior ethmoid removal performed. A diagnosis of ethmoid sinus disease alone does not establish the procedure.
How is bilateral surgery reported?
Report modifier 50 for bilateral performance. CMS pays the bilateral procedure at 150%.
What global and multiple-procedure rules apply?
The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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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