No office rate
31253 includes total ethmoidectomy with frontal sinus exploration. This code represents the frontal sinus work without that combined total ethmoidectomy service.
On this page
CMS RVU26D · Effective 2026-10-01
31276 Frontal sinus endoscopy Medicare reimbursement rates in Tennessee
Reports endoscopic surgical exploration of the frontal sinus, with removal of tissue when performed, commonly for obstructed frontal sinus drainage. Compare 31276 office and facility rates across CMS payment localities in Tennessee.
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 31276 in Tennessee?
Tennessee 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
$297.11
1 of 1 localities have a supported rate.
Payment area: Tennessee
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/sinus endoscopy
About 31276: Endoscopic frontal sinus exploration with tissue removal
Reports endoscopic surgical exploration of the frontal sinus, with removal of tissue when performed, commonly for obstructed frontal sinus drainage.
An otolaryngologist, often a rhinologist, uses an endoscope through the nasal cavity to surgically access and explore the frontal sinus. The procedure is commonly performed in an operating room for chronic frontal sinusitis or an obstructed frontal drainage pathway; tissue such as inflammatory tissue may be removed when indicated. The code represents frontal sinus work, not ethmoidectomy or balloon dilation alone.
Report it when the operative note supports surgical frontal sinus exploration and identifies the side treated; document any tissue removal and additional sinus procedures performed. A 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS applies endoscopy family pricing. For bilateral surgery, modifier 50 is paid at 150%. CMS does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 31276
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- 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 RVU6.58 · 69%
- Practice expense (office) RVU1.98 · 21%
- Malpractice RVU0.96 · 10%
12.5K
Medicare services in 2024 · #1360 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.
31276 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$1,461.18
31296 is for frontal sinus dilation using a dilation device. This code represents surgical exploration of the frontal sinus, with tissue removal when performed.
No office rate
31255 describes total ethmoidectomy without the frontal sinus exploration represented here.
Compare 31276 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$297.11
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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 31276 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
3,542
- Code
- 31276
- Physician work
- 6.58
- Practice expense
- 1.98
- Malpractice
- 0.96
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.58 | × 1.000 | 6.5800 |
| Practice expense | 1.98 | × 0.909 | 1.7998 |
| Malpractice | 0.96 | × 0.537 | 0.5155 |
| Total RVUs | 8.8953 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$297.11
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.58 | 1 |
| Practice expense | 1.98 | 0.909 |
| Malpractice | 0.96 | 0.537 |
(6.58 × 1 + 1.98 × 0.909 + 0.96 × 0.537) × $33.4009 = $297.11
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.
31276 billing questions
How does this differ from 31253?
31276 covers frontal sinus exploration. Use 31253 when the operative service also includes a total ethmoidectomy with the frontal sinus work.
When is 31296 more appropriate?
31296 describes endoscopic dilation of the frontal sinus with a dilation device. This code is for surgical frontal sinus exploration, with tissue removal when performed.
Can a separate sinus procedure be reported at the same operation?
A distinct procedure on another sinus may be reported when supported by the operative note. CMS applies endoscopy family pricing when related endoscopies are performed together.
How is bilateral frontal sinus surgery reported?
Report modifier 50 for bilateral surgery; CMS pays the bilateral procedure at 150%.
What global period and assistant rules apply?
The code has a 0-day global period, which includes same-day preoperative and postoperative care. CMS does not pay an assistant at surgery; 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.
3,53931259,,Nsl/sins ndsc sphn tiss rmvl,A,,8.27,2.40,NA,2.40,,1.22,11.89,11.89,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,54031267,,Endoscopy maxillary sinus,A,,4.56,1.49,NA,1.49,,0.66,6.71,6.71,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
3,5413126F,,Esoph bx rprt w/dyspl info,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780