Billing code 31085: Frontal sinus surgeryMedicare rate & RVUs in Texas
Reports a surgical frontal sinus procedure involving removal, selected from the operative technique and extent documented by the surgeon.
CMS doesn’t publish an office rate for 31085 in Texas.
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 31085 covers
This code is for surgical work on the frontal sinus in which removal is part of the procedure. Otolaryngologists typically perform frontal sinus surgery in an operating room, often for disease that requires operative treatment rather than office irrigation or diagnostic exploration. The operative report should identify the frontal sinus treated, the surgical approach, what was removed, and whether the sinus was left open or obliterated. Those details help distinguish this code from other frontal sinus procedures.
Choose among the neighboring frontal sinus codes according to the actual technique and extent documented, not simply the diagnosis or the phrase “frontal sinus removal.” This is major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. If multiple procedures are performed 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%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is 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 31085 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,137.31 |
| Beaumont | Unavailable | $1,060.91 |
| Brazoria | Unavailable | $1,096.98 |
| Dallas | Unavailable | $1,105.90 |
| Fort Worth | Unavailable | $1,101.55 |
| Galveston | Unavailable | $1,101.58 |
| Houston | Unavailable | $1,142.03 |
| Rest Of Texas | Unavailable | $1,079.69 |
How the 31085 rate is calculated
Each of 31085’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 · 31085
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.25Practice expense 15.89Malpractice 2.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31085
31085 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31085
Frontal sinus surgery
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 31085
Frontal sinus surgery
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
31085 without 50 · national facility
$1,113.92
Frontal sinus surgery
31085-50 · Bilateral: 150%
$1,670.88
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).
31085 compared with similar codes
Compare codes
31085 vs 31084 vs 31080 vs 31081: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31084Frontal sinus surgery
- Both concern frontal sinus surgery, but the specific procedure and method documented in the operative report determine which code applies.
- 31080Frontal sinus surgery
- This neighboring code describes an obliterative frontal sinus procedure without an osteoplastic flap; select based on the procedure actually performed.
- 31081Frontal sinus surgery
- This neighboring code describes an obliterative frontal sinus procedure using an osteoplastic flap; the operative technique is the key distinction.
31085 billing questions
How should this code be distinguished from other frontal sinus surgery codes?
Use the operative report to identify the specific approach, extent of removal, and whether the sinus was obliterated. The diagnosis alone does not establish which frontal sinus code applies.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and related postoperative care for 90 days.
How are multiple procedures handled in the same session?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction and paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, while team-surgery payment is not permitted.
How is bilateral surgery reported?
For a bilateral procedure, modifier 50 is paid at 150%.
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
Fee sheets
Put 31085 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →