CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 31086 RVU and Medicare Payment (2026)
Removal of frontal sinus — 14 work RVU, about $1,056.47 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 14
- PE RVU (non-facility)
- 15.58
- PE RVU (facility)
- 15.58
- MP RVU
- 2.05
- Office payment
- $1,056.47
- Facility payment
- $1,056.47
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 31086 in a non-facility setting with national GPCI: (14 + 15.58 + 2.05) × $33.4009 ≈ $1,056.47. The same code in a facility setting pays about $1,056.47 because facility PE RVU (15.58) replaces office PE RVU.
What changes by locality
GPCI moves 31086 non-facility payment from $949.89 to $1,306.15 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 31086?
14. 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 31086 in 2026?
About $1,056.47 non-facility ($1,056.47 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 (14) and malpractice RVU stay fixed; only practice expense changes (15.58 office vs 15.58 facility). That is the entire office-vs-facility payment gap.