Billing code 31201: EthmoidectomyMedicare rate & RVUs in Oregon
Reports total ethmoid air-cell removal through an intranasal approach for extensive ethmoid disease when the surgeon removes more than the anterior cells.
CMS doesn’t publish an office rate for 31201 in Oregon.
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 31201 covers
This operation removes the ethmoid air cells through the nasal cavity using an intranasal approach rather than a sinus endoscope. An otolaryngologist typically performs it in an operating room for extensive ethmoid disease, such as chronic ethmoid sinusitis or diffuse polyposis, when total ethmoid removal is required. The code represents total, not anterior-only, ethmoidectomy and is distinct from an external approach or endoscopic ethmoidectomy.
Report the code when the operative documentation supports total ethmoidectomy by the intranasal route. Document the approach, extent, side or sides treated, and indication. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral surgery reported with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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.
Where 31201 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $746.48 |
| Rest Of Oregon | Unavailable | $695.68 |
How the 31201 rate is calculated
Each of 31201’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 · 31201
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.39Practice expense 11.62Malpractice 1.23
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31201
31201 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31201
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) | 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 · 31201
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
31201 without 50 · national facility
$709.44
Ethmoidectomy
31201-50 · Bilateral: 150%
$1,064.16
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).
31201 compared with similar codes
Compare codes
31201 vs 31200 vs 31205 vs 31254 vs 31255: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31200Ethmoidectomy
- Use 31200 for anterior intranasal ethmoid removal. This code is for total ethmoidectomy through the intranasal approach.
- 31205Ethmoidectomy
- Both describe total ethmoid removal, but 31205 uses an external approach; this code uses an intranasal approach.
- 31254Ethmoidectomy
- 31254 is endoscopic partial ethmoidectomy. This code represents total ethmoidectomy by the intranasal approach.
- 31255Ethmoidectomy
- Both represent total ethmoidectomy, but 31255 is performed endoscopically; this code is for the intranasal approach.
31201 billing questions
How does this differ from code 31200?
This code represents total intranasal ethmoidectomy. Code 31200 is for anterior ethmoidectomy, so the documented extent of removal determines which code fits.
How does this differ from code 31255?
Code 31255 describes total ethmoidectomy performed endoscopically. This code is for the intranasal approach.
Can modifier 50 be reported for bilateral surgery?
Yes. CMS lists this as a bilateral procedure; when reported with modifier 50, it is paid at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.
Can an assistant or co-surgeon be paid?
CMS lists a statutory restriction on assistant-at-surgery payment. Co-surgeons and team surgery are not permitted.
What documentation supports reporting total ethmoidectomy?
The operative report should establish the intranasal approach and total rather than anterior-only ethmoid removal, and identify the side or sides treated.
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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