No office rate
31070 describes frontal sinus exploration. Use 31086 when the operation is the frontal sinus removal variant, rather than exploration alone.
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CMS RVU26D · Effective 2026-10-01
31086 Frontal sinus surgery Medicare reimbursement rates in Utah
Frontal sinus removal surgery is reported when an operative procedure removes frontal sinus tissue rather than merely exploring or irrigating the sinus. Compare 31086 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 31086 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
$1018.26
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.
Otolaryngology surgery
About 31086: Frontal sinus removal surgery
Frontal sinus removal surgery is reported when an operative procedure removes frontal sinus tissue rather than merely exploring or irrigating the sinus.
Code 31086 represents an operative removal procedure involving the frontal sinus, the air cavity above the eyes that drains into the nasal passages. It is distinct from a procedure limited to examining or opening the sinus. Otolaryngologists and surgeons who manage complex frontal sinus disease may perform this work in an operating room for conditions such as persistent inflammatory disease, a mucocele, or a lesion requiring surgical removal. The operative report should identify the frontal sinus as the treated site and describe the tissue removed and the operative extent.
Report 31086 when the documented operation matches this frontal sinus removal variant, not solely because the diagnosis involves frontal sinus disease. Record the approach, anatomic extent, and concurrent procedures; use the applicable sibling code when the operative details fit another variant. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 31086
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.00 · 44%
- Practice expense (office) RVU15.58 · 49%
- Malpractice RVU2.05 · 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.
31086 compared with similar codes
Office rates for Utah, from the same CMS release.
31075
No office rateFrontal sinus exploration
31075 is also a frontal sinus exploration code. The operative report should support removal work for 31086 rather than exploration alone.
No office rate
31084 is a sibling frontal sinus removal code. Distinguish it from 31086 by matching the documented operative technique and extent to the applicable CPT variant.
Compare 31086 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
$1018.26
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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 31086 in Utah.
PPRRVU2026_Oct_nonQPP.csv
3,508
- Code
- 31086
- Physician work
- 14.00
- Practice expense
- 15.58
- Malpractice
- 2.05
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.00 | × 1.000 | 14.0000 |
| Practice expense | 15.58 | × 0.940 | 14.6452 |
| Malpractice | 2.05 | × 0.898 | 1.8409 |
| Total RVUs | 30.4861 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$1018.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14 | 1 |
| Practice expense | 15.58 | 0.94 |
| Malpractice | 2.05 | 0.898 |
(14 × 1 + 15.58 × 0.94 + 2.05 × 0.898) × $33.4009 = $1018.26
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.
31086 billing questions
How is 31086 different from a frontal sinus exploration code?
31086 represents a removal procedure. Codes 31070 and 31075 describe frontal sinus exploration; use an exploration code when the documented work is limited to exploration rather than the removal procedure represented by 31086.
What should the operative report document?
Document the frontal sinus as the operative site, the approach and extent of the procedure, and the tissue removed. Those details help distinguish 31086 from exploration and from other frontal sinus removal variants.
How does modifier 50 affect payment?
CMS identifies this as a bilateral procedure: reporting modifier 50 results in payment at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be made. CMS does not permit co-surgeons or team surgery for this code.
How is 31086 affected when other procedures are performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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.
3,50531081,,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
3,50731085,,Removal of frontal sinus,A,,15.25,15.89,NA,15.89,,2.21,33.35,33.35,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50831086,,Removal of frontal sinus,A,,14.00,15.58,NA,15.58,,2.05,31.63,31.63,0,090,0.10,0.76,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,50931087,,Removal of frontal sinus,A,,14.21,13.68,NA,13.68,,2.07,29.96,29.96,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,51031090,,Exploration of sinuses,A,,10.89,17.80,NA,17.80,,1.59,30.28,30.28,0,090,0.10,0.76,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,5113110F,,Pres/absn hmrhg/lesion docd,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
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