$623.83
Both use a radical Caldwell-Luc approach. The distinction is whether an antrochoanal polyp is removed: removal supports 31032; no polyp removal supports 31030.
On this page
CMS RVU26D · Effective 2026-10-01
31032 Maxillary sinus surgery Medicare reimbursement rates in Utah
Open maxillary sinus surgery with removal of an antrochoanal polyp, reported when the surgeon uses a Caldwell-Luc approach rather than an endoscopic route. Compare 31032 office and facility rates across CMS payment localities in Utah.
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 31032 in Utah?
Utah 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
$530.44
1 of 1 localities have a supported rate.
Payment area: Utah
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 31032: Caldwell-Luc maxillary sinus polyp removal
Open maxillary sinus surgery with removal of an antrochoanal polyp, reported when the surgeon uses a Caldwell-Luc approach rather than an endoscopic route.
An otolaryngologist performs an open Caldwell-Luc operation to enter the maxillary sinus and remove an antrochoanal polyp. These polyps arise in the maxillary sinus and may extend toward the nasal cavity or choana. The surgeon documents the maxillary sinus approach and the polyp removal; this is distinct from transnasal endoscopic sinus surgery. The procedure is generally performed in a surgical facility, consistent with Medicare’s 2024 claims showing facility services for this code.
Select this code when the operative report supports the open radical maxillary sinus approach and removal of the polyp. Medicare treats it as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral surgery reported with modifier 50, payment is at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 31032
- 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 RVU6.52 · 39%
- Practice expense (office) RVU9.07 · 55%
- Malpractice RVU0.93 · 6%
97
Medicare services in 2024 · #4906 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.
31032 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
31267 is performed endoscopically through the nasal route and includes tissue removal from the maxillary sinus. 31032 describes the open Caldwell-Luc approach with polyp removal.
No office rate
31256 describes endoscopic maxillary antrostomy without tissue removal. 31032 is an open Caldwell-Luc operation that includes removal of an antrochoanal polyp.
Compare 31032 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
Utah →
Office / nonfacility
Unavailable
Facility
$530.44
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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 31032 in Utah.
PPRRVU2026_Oct_nonQPP.csv
3,498
- Code
- 31032
- Physician work
- 6.52
- Practice expense
- 9.07
- Malpractice
- 0.93
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.52 | × 1.000 | 6.5200 |
| Practice expense | 9.07 | × 0.940 | 8.5258 |
| Malpractice | 0.93 | × 0.898 | 0.8351 |
| Total RVUs | 15.8809 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$530.44
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.52 | 1 |
| Practice expense | 9.07 | 0.94 |
| Malpractice | 0.93 | 0.898 |
(6.52 × 1 + 9.07 × 0.94 + 0.93 × 0.898) × $33.4009 = $530.44
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.
31032 billing questions
How does this differ from 31030?
Both describe a radical Caldwell-Luc approach to the maxillary sinus. Use 31032 when the surgeon also removes an antrochoanal polyp; 31030 is the corresponding procedure without polyp removal.
When is 31267 a better fit?
31267 describes endoscopic maxillary antrostomy with tissue removal. Use 31032 for the open Caldwell-Luc approach with polyp removal, not an endoscopic route.
What documentation supports 31032?
The operative report should identify the open Caldwell-Luc approach, the maxillary sinus treated, and removal of an antrochoanal polyp.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; Medicare payment is at 150%.
Can an assistant or co-surgeon be billed?
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.
3,4953100F,,Image test ref carot diam,I,,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
3,49631020,,Exploration maxillary sinus,A,,2.99,9.57,,6.43,,0.37,12.93,9.79,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49731030,,Exploration maxillary sinus,A,,5.86,12.89,,7.56,,0.78,19.53,14.20,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,49831032,,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
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985