Billing code 31267: Sinus endoscopyMedicare rate & RVUs in Utah
Reports endoscopic maxillary sinus surgery that opens the sinus and removes tissue from within it, such as polypoid or diseased tissue.
CMS doesn’t publish an office rate for 31267 in Utah.
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 31267 covers
An otolaryngologist or rhinologist performs this endoscopic operation to access the maxillary sinus, enlarge its opening, and remove tissue from inside the sinus. Typical clinical situations include chronic maxillary sinus disease with polyps or other obstructive tissue. The operative report should establish that tissue was removed from the maxillary sinus, not merely from the nasal cavity or the sinus opening. The service is performed in an office or facility setting, depending on the case and where the surgery takes place.
Report the code when the operative work includes both maxillary sinus access and tissue removal from that sinus; an opening without tissue removal is a different service. Document the side, endoscopic work, tissue removed, and any other sinus procedures performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral surgery, modifier 50 is paid at 150%. When related endoscopies are performed together, endoscopy family pricing applies. CMS does not pay an assistant at surgery, and co-surgeons and team surgery are 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.
31267 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $218.89 |
How the 31267 rate is calculated
Each of 31267’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 · 31267
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.56Practice expense 1.49Malpractice 0.66
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31267
The CMS indicators that decide how 31267 is paid alongside other services.
CMS payment indicators · 31267
Sinus endoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
31267 without 50 · national facility
$224.12
Sinus endoscopy
31267-50 · Bilateral: 150%
$336.18
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).
31267 compared with similar codes
Compare codes
31267 vs 31256 vs 31276 vs 31288: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31256Maxillary antrostomy
- 31256 covers maxillary sinus endoscopy without tissue removal from inside the sinus. Choose 31267 when that tissue removal is documented.
- 31276Frontal sinus endoscopy
- 31276 represents endoscopic frontal sinus surgery with tissue removal. The sinus treated, rather than the general use of endoscopy, distinguishes it from 31267.
- 31288Sphenoid surgery
- 31288 represents endoscopic sphenoid sinus surgery with tissue removal. Use 31267 for the corresponding maxillary sinus work.
31267 billing questions
How does this differ from 31256?
Use 31267 when tissue is removed from within the maxillary sinus as part of the endoscopic work. 31256 represents maxillary sinus access without that tissue removal.
Does tissue removed from the nasal cavity qualify?
No. The documentation should identify tissue removed from inside the maxillary sinus; removal limited to the nasal cavity or sinus opening does not establish that work.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure. Report modifier 50 for bilateral surgery; CMS pays it at 150%.
Can another related sinus endoscopy be reported at the same session?
A separate endoscopic procedure may be reported when the operative work supports it at another sinus site. CMS endoscopy family pricing applies when related endoscopies are performed together.
What is the global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can an assistant or co-surgeon be reported?
CMS 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 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
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