No office rate
This code represents frontal sinus removal. Code 31070 is for frontal sinus exploration, so use it when the documented service is exploration rather than removal.
On this page
CMS RVU26D · Effective 2026-10-01
31087 Frontal sinus surgery Medicare reimbursement rates in Utah
Reports operative removal involving the frontal sinus, rather than irrigation or exploration alone, when the documented procedure matches this code’s removal service. Compare 31087 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 31087 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
$966.22
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 31087: Frontal sinus removal surgery
Reports operative removal involving the frontal sinus, rather than irrigation or exploration alone, when the documented procedure matches this code’s removal service.
An otolaryngologist performs this operation on the frontal sinus, the air space above the eyes and behind the forehead. It represents a removal procedure, not simply flushing the sinus or opening it to inspect or explore it. The operative report should make clear what was removed and the extent and side of the frontal sinus work. Frontal sinus operations may be performed for significant sinus disease or another condition requiring operative treatment, but the procedure documented—not the diagnosis alone—determines code selection.
Report the code when the documented operation matches its removal service; distinguish it from frontal sinus exploration and from other frontal sinus procedure codes by the specific technique and extent described in the operative note. The note should identify the treated side or sides and the work performed. Medicare 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% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 31087
- 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 RVU14.21 · 47%
- Practice expense (office) RVU13.68 · 46%
- Malpractice RVU2.07 · 7%
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.
31087 compared with similar codes
Office rates for Utah, from the same CMS release.
31075
No office rateFrontal sinus exploration
Code 31075 also describes frontal sinus exploration. The operative note must support removal work to report 31087.
No office rate
Both codes are in the frontal sinus removal family. Distinguish them by the specific procedure and technique documented and the applicable CPT descriptor, not by the abbreviated CMS label alone.
Compare 31087 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
$966.22
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 31087 in Utah.
PPRRVU2026_Oct_nonQPP.csv
3,509
- Code
- 31087
- Physician work
- 14.21
- Practice expense
- 13.68
- Malpractice
- 2.07
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.21 | × 1.000 | 14.2100 |
| Practice expense | 13.68 | × 0.940 | 12.8592 |
| Malpractice | 2.07 | × 0.898 | 1.8589 |
| Total RVUs | 28.9281 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$966.22
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.21 | 1 |
| Practice expense | 13.68 | 0.94 |
| Malpractice | 2.07 | 0.898 |
(14.21 × 1 + 13.68 × 0.94 + 2.07 × 0.898) × $33.4009 = $966.22
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.
31087 billing questions
How is this different from frontal sinus exploration?
This code represents removal work involving the frontal sinus. Codes 31070 and 31075 describe frontal sinus exploration, so the operative report must support removal rather than exploration alone.
What documentation supports reporting this code?
Document the frontal sinus procedure performed, what was removed, the extent and side of the work, and the operative technique. The note should support choosing this removal code over an exploration code or another frontal sinus procedure.
How are related postoperative visits handled?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral service at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction.
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.
3,50631084,,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
3,5123111F,,Ct/mri brain done w/in 24hrs,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