Billing code 31276: Frontal sinus endoscopyMedicare rate & RVUs in Washington
Reports endoscopic surgical exploration of the frontal sinus, with removal of tissue when performed, commonly for obstructed frontal sinus drainage.
CMS doesn’t publish an office rate for 31276 in Washington.
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 31276 covers
An otolaryngologist, often a rhinologist, uses an endoscope through the nasal cavity to surgically access and explore the frontal sinus. The procedure is commonly performed in an operating room for chronic frontal sinusitis or an obstructed frontal drainage pathway; tissue such as inflammatory tissue may be removed when indicated. The code represents frontal sinus work, not ethmoidectomy or balloon dilation alone.
Report it when the operative note supports surgical frontal sinus exploration and identifies the side treated; document any tissue removal and additional sinus procedures performed. A 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS applies endoscopy family pricing. For bilateral surgery, modifier 50 is paid at 150%. 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.
Where 31276 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $316.68 |
| Seattle (King Cnty) | Unavailable | $338.11 |
How the 31276 rate is calculated
Each of 31276’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 · 31276
RVUs × geographic indexes × conversion factor
Work6.58
6.58 RVUs× 1.000 GPCI
Practice expense1.98
1.98 RVUs× 1.000 GPCI
Malpractice0.96
0.96 RVUs× 1.000 GPCI
Adjusted RVUs
9.5200
Conversion factor
$33.4009
Medicare rate
$317.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31276
The CMS indicators that decide how 31276 is paid alongside other services.
CMS payment indicators · 31276
Frontal 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
31276 without 50 · national facility
$317.98
Frontal sinus endoscopy
31276-50 · Bilateral: 150%
$476.97
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).
31276 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31253Sinus endoscopy
- 31253 includes total ethmoidectomy with frontal sinus exploration. This code represents the frontal sinus work without that combined total ethmoidectomy service.
- 31296Sinus dilation
- 31296 is for frontal sinus dilation using a dilation device. This code represents surgical exploration of the frontal sinus, with tissue removal when performed.
- 31255Ethmoidectomy
- 31255 describes total ethmoidectomy without the frontal sinus exploration represented here.
31276 billing questions
How does this differ from 31253?
31276 covers frontal sinus exploration. Use 31253 when the operative service also includes a total ethmoidectomy with the frontal sinus work.
When is 31296 more appropriate?
31296 describes endoscopic dilation of the frontal sinus with a dilation device. This code is for surgical frontal sinus exploration, with tissue removal when performed.
Can a separate sinus procedure be reported at the same operation?
A distinct procedure on another sinus may be reported when supported by the operative note. CMS applies endoscopy family pricing when related endoscopies are performed together.
How is bilateral frontal sinus surgery reported?
Report modifier 50 for bilateral surgery; CMS pays the bilateral procedure at 150%.
What global period and assistant rules apply?
The code has a 0-day global period, which includes same-day preoperative and postoperative care. CMS does not pay an assistant at surgery; 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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