No office rate
Both codes concern frontal sinus exploration. Review the full CPT descriptors and operative documentation to select the applicable service; the CMS short labels alone do not establish the distinction.
On this page
CMS RVU26D · Effective 2026-10-01
31075 Frontal sinus exploration Medicare reimbursement rates in Utah
Reports surgical exploration directed at the frontal sinus, including operative assessment of disease and any tissue removal performed as part of that exploration. Compare 31075 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 31075 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
$721.24
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 31075: Frontal sinus surgical exploration
Reports surgical exploration directed at the frontal sinus, including operative assessment of disease and any tissue removal performed as part of that exploration.
An otolaryngologist surgically accesses the frontal sinus to inspect or evaluate disease within that sinus; tissue may also be removed during the exploration. The operative report should identify the frontal sinus as the target and describe what the surgeon did there. This is distinct from routine nasal examination or irrigation of a sinus.
Report the service when the documented operation supports frontal sinus exploration, rather than selecting a code solely from a diagnosis such as chronic sinusitis. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 31075
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.27 · 41%
- Practice expense (office) RVU11.83 · 53%
- Malpractice RVU1.34 · 6%
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.
31075 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
31276 applies to endoscopic frontal sinus surgery performed through the nasal passages. This code represents a different frontal sinus exploration service; select according to the documented operative method and CPT descriptor.
No office rate
31080 represents a frontal sinusotomy procedure, while 31075 is reported for frontal sinus exploration. The operative report should support which procedure was performed.
Compare 31075 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
$721.24
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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 31075 in Utah.
PPRRVU2026_Oct_nonQPP.csv
3,503
- Code
- 31075
- Physician work
- 9.27
- Practice expense
- 11.83
- Malpractice
- 1.34
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.27 | × 1.000 | 9.2700 |
| Practice expense | 11.83 | × 0.940 | 11.1202 |
| Malpractice | 1.34 | × 0.898 | 1.2033 |
| Total RVUs | 21.5935 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$721.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.27 | 1 |
| Practice expense | 11.83 | 0.94 |
| Malpractice | 1.34 | 0.898 |
(9.27 × 1 + 11.83 × 0.94 + 1.34 × 0.898) × $33.4009 = $721.24
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.
31075 billing questions
How is this code distinguished from 31276?
31276 describes endoscopic frontal sinus surgery performed through the nasal passages. Use the code that matches the documented operative method and the applicable CPT descriptor.
What documentation supports reporting frontal sinus exploration?
The operative report should identify the frontal sinus as the surgical target and describe the access, findings, and any tissue removal performed.
How does the multiple-procedure reduction affect this service?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
Can modifier 50 be used for bilateral surgery?
Yes. CMS treats this as a bilateral procedure when reported with modifier 50 and pays it at 150%.
Is an assistant surgeon payable?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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.
3,50031050,,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
3,50231070,,Exploration of frontal sinus,A,,4.29,8.35,NA,8.35,,0.62,13.26,13.26,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50331075,,Exploration of frontal sinus,A,,9.27,11.83,NA,11.83,,1.34,22.44,22.44,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50431080,,Removal of frontal sinus,A,,12.42,15.20,NA,15.20,,1.80,29.42,29.42,0,090,0.10,0.76,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50531081,,Removal of frontal sinus,A,,13.84,15.54,NA,15.54,,2.02,31.40,31.40,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50631084,,Removal of frontal sinus,A,,14.58,15.72,NA,15.72,,2.13,32.43,32.43,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,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