CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 31030 RVU and Medicare Payment (2026)
Exploration maxillary sinus — 5.86 work RVU, about $652.32 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.86
- PE RVU (non-facility)
- 12.89
- PE RVU (facility)
- 7.56
- MP RVU
- 0.78
- Office payment
- $652.32
- Facility payment
- $474.29
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 31030 in a non-facility setting with national GPCI: (5.86 + 12.89 + 0.78) × $33.4009 ≈ $652.32. The same code in a facility setting pays about $474.29 because facility PE RVU (7.56) replaces office PE RVU.
What changes by locality
GPCI moves 31030 non-facility payment from $578.98 to $852.06 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 31030?
5.86. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 31030 in 2026?
About $652.32 non-facility ($474.29 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (5.86) and malpractice RVU stay fixed; only practice expense changes (12.89 office vs 7.56 facility). That is the entire office-vs-facility payment gap.