CPT 31254

Nasal/Sinus Ndsc W/Partial Ethmoidectomy

CPT 31254 pays $436.55 in a non-facility setting and $205.75 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $387.69 in Arkansas to $515.07 in Alaska, a 33% spread.

National non-facility rate

$436.55

Office and other outpatient settings

Facility rate
$205.75

Hospital and ASC settings

Highest state
$515.07

Alaska

Lowest state
$387.69

Arkansas · 33% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $436.55
CPT 31254 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $436.55, national facility $205.75.
StateRate compared visuallyNon-facilityFacility
Alaska
$515.07$269.26
District of Columbia
$495.72$223.84
California
$483.23$210.13
New York
$482.43$224.95
New Jersey
$480.33$220.45
Washington
$475.56$212.44
Massachusetts
$471.65$212.35
Hawaii
$466.14$203.72
Connecticut
$464.91$216.34
Florida
$456.45$224.88
Maryland
$451.71$211.10
Colorado
$451.59$206.02
Oregon
$446.97$203.82
Rhode Island
$446.18$207.77
Illinois
$445.93$222.91
New Hampshire
$445.42$205.16
Puerto Rico
$439.30$205.96
Virgin Islands
$439.30$205.96
Montana
$436.51$205.71
Pennsylvania
$433.49$207.42
Nevada
$433.48$202.45
Delaware
$431.89$203.86
Texas
$431.59$204.36
Wyoming
$431.34$200.54
Minnesota
$430.49$193.00
Georgia
$427.93$207.74
Michigan
$427.79$211.06
Virginia
$425.94$199.06
Arizona
$425.06$201.41
North Dakota
$424.65$193.85
Vermont
$423.87$195.38
South Dakota
$423.24$192.44
Utah
$417.85$200.90
New Mexico
$417.54$205.90
Maine
$416.71$196.18
Missouri
$413.38$201.59
Louisiana
$413.34$202.62
Ohio
$412.56$201.84
South Carolina
$412.45$199.19
Wisconsin
$411.02$189.92
North Carolina
$410.72$195.38
West Virginia
$408.83$208.26
Indiana
$405.99$192.04
Kentucky
$404.04$198.86
Idaho
$403.78$191.45
Nebraska
$402.71$189.68
Oklahoma
$402.38$196.28
Tennessee
$402.01$192.22
Iowa
$400.87$189.69
Kansas
$399.96$191.32
Alabama
$393.16$191.21
Mississippi
$392.74$194.02
Arkansas
$387.69$189.44

Billed by 1 specialties

Commercial rates for 31254

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates