No office rate
31070 is a frontal sinus exploration procedure. Report 31084 only when the documented operation meets its removal-procedure definition.
On this page
CMS RVU26D · Effective 2026-10-01
31084 Frontal sinus surgery Medicare reimbursement rates in Wisconsin
Reports a frontal sinus operation involving removal, selected when the operative documentation supports this specific procedure rather than exploration alone. Compare 31084 office and facility rates across CMS payment localities in Wisconsin.
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 31084 in Wisconsin?
Wisconsin 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
$1011.91
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 31084: Frontal sinus removal procedure
Reports a frontal sinus operation involving removal, selected when the operative documentation supports this specific procedure rather than exploration alone.
Code 31084 represents a surgical procedure involving removal in the frontal sinus. Otolaryngologists typically perform this type of operation in an operating room for significant frontal sinus disease or a lesion requiring surgical treatment. The operative report should identify the frontal sinus as the treated site and describe the work performed; do not infer this code from a diagnosis or from sinus access alone.
Select this code by matching the documented procedure and approach to its full CPT definition, especially when distinguishing it from other frontal sinus surgery codes. The 90-day global period includes 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. For bilateral reporting with modifier 50, CMS payment is 150%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 31084
- 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 RVU14.58 · 45%
- Practice expense (office) RVU15.72 · 48%
- Malpractice RVU2.13 · 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.
31084 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
31075
No office rateFrontal sinus exploration
31075 also describes frontal sinus exploration. The operative work and approach, rather than the diagnosis alone, determine whether 31084 is appropriate.
No office rate
Both are frontal sinus removal procedures, but they have distinct CPT definitions. Match the code to the operative technique documented.
Compare 31084 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$1011.91
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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 31084 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
3,506
- Code
- 31084
- Physician work
- 14.58
- Practice expense
- 15.72
- Malpractice
- 2.13
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.58 | × 1.000 | 14.5800 |
| Practice expense | 15.72 | × 0.958 | 15.0598 |
| Malpractice | 2.13 | × 0.308 | 0.6560 |
| Total RVUs | 30.2958 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$1011.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.58 | 1 |
| Practice expense | 15.72 | 0.958 |
| Malpractice | 2.13 | 0.308 |
(14.58 × 1 + 15.72 × 0.958 + 2.13 × 0.308) × $33.4009 = $1011.91
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.
31084 billing questions
How is 31084 distinguished from frontal sinus exploration codes?
Use 31084 when the documented operation meets its removal-procedure definition. Codes 31070 and 31075 represent frontal sinus exploration procedures, so access or exploration alone does not establish 31084.
What documentation supports reporting 31084?
The operative report should identify the frontal sinus, describe the removal performed, and document the surgical approach and extent needed to support selection over other frontal sinus procedure codes.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is modifier 50 handled for a bilateral procedure?
CMS pays a bilateral procedure reported with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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.
3,50331075,,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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,