Billing code 31288: Sphenoid surgeryMedicare rate & RVUs in Ohio
Report this endoscopic sphenoid sinus operation when the surgeon opens the sinus and removes tissue, such as a polyp or diseased tissue.
CMS doesn’t publish an office rate for 31288 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 31288 covers
An otolaryngologist typically performs this endoscopic operation through the nasal passage to open the sphenoid sinus and remove tissue from within it. It may be performed for sphenoid disease when tissue, such as a polyp or diseased mucosa, is removed as part of the sinus procedure. The operative note should identify the sphenoid sinus treated, describe the opening and tissue removal, and record laterality and any additional sinus procedures.
Select this code when the sphenoid procedure includes tissue removal; a sphenoidotomy without tissue removal is a different service. CMS applies endoscopy-family pricing when related endoscopies are performed together. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For a bilateral procedure, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.
31288 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $194.30 |
How the 31288 rate is calculated
Each of 31288’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 · 31288
RVUs × geographic indexes × conversion factor
Work4.00
4.00 RVUs× 1.000 GPCI
Practice expense1.35
1.35 RVUs× 1.000 GPCI
Malpractice0.58
0.58 RVUs× 1.000 GPCI
Adjusted RVUs
5.9300
Conversion factor
$33.4009
Medicare rate
$198.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31288
The CMS indicators that decide how 31288 is paid alongside other services.
CMS payment indicators · 31288
Sphenoid surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
31288 without 50 · national facility
$198.07
Sphenoid surgery
31288-50 · Bilateral: 150%
$297.11
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).
31288 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31287Sphenoidotomy
- 31287 covers sphenoidotomy without tissue removal from the sphenoid sinus. Choose 31288 when the surgeon also removes tissue from that sinus.
- 31259Sinus endoscopy
- 31259 includes total ethmoidectomy along with sphenoidotomy and sphenoid tissue removal. Use 31288 for the sphenoid procedure without that included total ethmoidectomy.
- 31257Sinus endoscopy
- 31257 includes total ethmoidectomy and sphenoidotomy without sphenoid tissue removal. Code 31288 describes sphenoid tissue removal without the included ethmoidectomy.
- 31267Sinus endoscopy
- 31267 applies to maxillary sinus surgery with tissue removal; 31288 is for tissue removal from the sphenoid sinus.
31288 billing questions
How does this differ from 31287?
Use 31288 when tissue is removed from the sphenoid sinus during the endoscopic procedure. Code 31287 describes sphenoidotomy without tissue removal.
Can an ethmoidectomy also be reported?
A separately performed ethmoidectomy may be reported when supported by the operative documentation. When related endoscopies are performed together, CMS endoscopy-family pricing applies.
What supports reporting tissue removal?
The operative report should document tissue removal from the sphenoid sinus, along with the sinus treated and the surgical work performed. A sinus opening alone does not support the tissue-removal distinction.
How is a bilateral procedure reported?
Report modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
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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