No office rate
Both codes report endoscopic CSF leak repair, but the repair site determines the choice: ethmoid region for 31290 and sphenoid region for 31291.
On this page
CMS RVU26D · Effective 2026-10-01
31290 CSF leak repair Medicare reimbursement rates in Rhode Island
Reports endoscopic repair of a cerebrospinal fluid leak at the ethmoid region, such as a skull-base defect causing clear nasal drainage. Compare 31290 office and facility rates across CMS payment localities in Rhode Island.
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 31290 in Rhode Island?
Rhode Island 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
$1003.23
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Nasal and sinus surgery
About 31290: Endoscopic ethmoid CSF leak repair
Reports endoscopic repair of a cerebrospinal fluid leak at the ethmoid region, such as a skull-base defect causing clear nasal drainage.
An otolaryngologist, often a rhinologist, uses a nasal endoscope to locate and close a cerebrospinal fluid leak involving the ethmoid region of the skull base. The repair may use graft material or a vascularized flap to seal the defect. Typical situations include persistent clear nasal drainage from a spontaneous, traumatic, or prior surgical skull-base opening. The procedure is generally performed in an operating room, commonly in a hospital outpatient or inpatient setting.
Report 31290 when the operative documentation identifies repair of a CSF leak in the ethmoid region; a sinus exploration or ethmoidectomy alone is not this service. The operative report should support the leak site and describe the endoscopic repair. CMS assigns a 10-day global period, which includes related postoperative visits during that period. When related nasal or sinus endoscopies are performed together, endoscopy-family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 31290
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.14 · 61%
- Practice expense (office) RVU8.73 · 29%
- Malpractice RVU2.84 · 10%
95
Medicare services in 2024 · #4922 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.
31290 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$446.18
31254 reports partial ethmoidectomy, not repair of a CSF leak. Use 31290 when the documented service is endoscopic closure of an ethmoid-region leak.
No office rate
31255 reports total ethmoidectomy. It is not a substitute for 31290 when the procedure repairs an ethmoid-region CSF leak.
No office rate
31288 involves sphenoidotomy with tissue removal. It does not describe repair of a CSF leak in the ethmoid region.
Compare 31290 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$1003.23
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 31290 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
3,545
- Code
- 31290
- Physician work
- 18.14
- Practice expense
- 8.73
- Malpractice
- 2.84
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.14 | × 1.019 | 18.4847 |
| Practice expense | 8.73 | × 1.033 | 9.0181 |
| Malpractice | 2.84 | × 0.892 | 2.5333 |
| Total RVUs | 30.0360 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1003.23
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.14 | 1.019 |
| Practice expense | 8.73 | 1.033 |
| Malpractice | 2.84 | 0.892 |
(18.14 × 1.019 + 8.73 × 1.033 + 2.84 × 0.892) × $33.4009 = $1003.23
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.
31290 billing questions
How is 31290 distinguished from 31291?
31290 is for endoscopic CSF leak repair in the ethmoid region. Use 31291 when the documented leak site is the sphenoid region.
Is an ethmoidectomy the same service as 31290?
No. An ethmoidectomy removes ethmoid sinus tissue, while 31290 reports endoscopic repair of a CSF leak at the ethmoid region. Select the code from the documented procedure.
How should bilateral repair be reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Are postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the 10-day global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.
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.
3,54231276,,Nsl/sins ndsc frnt tiss rmvl,A,,6.58,1.98,NA,1.98,,0.96,9.52,9.52,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54331287,,Nasal/sinus endoscopy surg,A,,3.41,1.21,NA,1.21,,0.48,5.10,5.10,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54431288,,Nasal/sinus endoscopy surg,A,,4.00,1.35,NA,1.35,,0.58,5.93,5.93,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54531290,,Nasal/sinus endoscopy surg,A,,18.14,8.73,NA,8.73,,2.84,29.71,29.71,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54631291,,Nasal/sinus endoscopy surg,A,,19.07,9.50,NA,9.50,,3.67,32.24,32.24,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54731292,,Nsl/sins ndsc med/inf dcmprn,A,,15.50,7.80,NA,7.80,,2.28,25.58,25.58,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54831293,,Nsl/sins ndsc med&inf dcmprn,A,,17.03,8.12,NA,8.12,,2.49,27.64,27.64,0,010,0.10,0.80,0.10,3,1,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537