No office rate
Choose 31051 when tissue is removed from the sphenoid sinus; 31050 represents sphenoid surgery without tissue removal.
On this page
CMS RVU26D · Effective 2026-10-01
31051 Sphenoid surgery Medicare reimbursement rates in Oklahoma
Reports surgery opening a sphenoid sinus and removing tissue, such as diseased mucosa or a lesion, when documented in the operative report. Compare 31051 office and facility rates across CMS payment localities in Oklahoma.
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 31051 in Oklahoma?
Oklahoma has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$588.51
1 of 1 localities have a supported rate.
Payment area: Oklahoma
One mapped payment locality.
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.
Sinus surgery
About 31051: Sphenoid sinus surgery with tissue removal
Reports surgery opening a sphenoid sinus and removing tissue, such as diseased mucosa or a lesion, when documented in the operative report.
This service involves surgically opening the sphenoid sinus and removing tissue from within it. Otolaryngologists commonly perform it in an operating room for sphenoid disease requiring more than irrigation or an opening alone. The operative report should identify the sphenoid sinus treated and describe both the surgical opening and the tissue removed.
Report this code when tissue removal accompanies the sphenoid sinus surgery; an opening without tissue removal is represented by a different code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 31051
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
- 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 RVU7.07 · 37%
- Practice expense (office) RVU10.90 · 57%
- Malpractice RVU1.05 · 6%
13
Medicare services in 2024 · #6124 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.
31051 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
31287 describes endoscopic sphenoid surgery without tissue removal. This code includes tissue removal and does not specify an endoscopic approach.
No office rate
31288 describes endoscopic sphenoid surgery with tissue removal. Use the code that fits the documented approach and service.
Compare 31051 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.
1 of 1 payment localities
Oklahoma →
Office / nonfacility
Unavailable
Facility
$588.51
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 31051 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
3,501
- Code
- 31051
- Physician work
- 7.07
- Practice expense
- 10.90
- Malpractice
- 1.05
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.07 | × 1.000 | 7.0700 |
| Practice expense | 10.90 | × 0.893 | 9.7337 |
| Malpractice | 1.05 | × 0.777 | 0.8159 |
| Total RVUs | 17.6196 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$588.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.07 | 1 |
| Practice expense | 10.9 | 0.893 |
| Malpractice | 1.05 | 0.777 |
(7.07 × 1 + 10.9 × 0.893 + 1.05 × 0.777) × $33.4009 = $588.51
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
31051 billing questions
How does this differ from 31050?
Use 31051 when tissue is removed from the sphenoid sinus during surgery. Code 31050 represents sphenoid sinus surgery without that tissue removal.
How does this differ from 31288?
Code 31288 describes endoscopic sphenoid sinus surgery with tissue removal. Choose the code that matches the documented surgical approach and service.
What should the operative report document?
Document the sphenoid sinus treated, the surgical opening, and the tissue removed. The record should make clear that tissue removal was part of the procedure.
How is bilateral surgery reported?
For bilateral surgery, report modifier 50; CMS pays this code at 150% when billed bilaterally.
Are assistant or co-surgeon services payable?
Medicare 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.
3,49831032,,Explore sinus remove polyps,A,,6.52,9.07,NA,9.07,,0.93,16.52,16.52,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49931040,,Exploration behind upper jaw,A,,9.53,10.65,NA,10.65,,1.43,21.61,21.61,0,090,0.10,0.76,0.14,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50031050,,Exploration sphenoid sinus,A,,5.24,8.26,NA,8.26,,0.78,14.28,14.28,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50131051,,Sphenoid sinus surgery,A,,7.07,10.90,NA,10.90,,1.05,19.02,19.02,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50231070,,Exploration of frontal sinus,A,,4.29,8.35,NA,8.35,,0.62,13.26,13.26,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50331075,,Exploration of frontal sinus,A,,9.27,11.83,NA,11.83,,1.34,22.44,22.44,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50431080,,Removal of frontal sinus,A,,12.42,15.20,NA,15.20,,1.80,29.42,29.42,0,090,0.10,0.76,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193