CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 31231 RVU and Medicare Payment (2026)

Nasal endoscopy dx — 1.07 work RVU, about $193.39 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
1.07
PE RVU (non-facility)
4.56
PE RVU (facility)
0.41
MP RVU
0.16
Office payment
$193.39
Facility payment
$54.78

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 31231 in a non-facility setting with national GPCI: (1.07 + 4.56 + 0.16) × $33.4009 ≈ $193.39. The same code in a facility setting pays about $54.78 because facility PE RVU (0.41) replaces office PE RVU.

What changes by locality

GPCI moves 31231 non-facility payment from $169.32 to $262.16 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 31231?

1.07. 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 31231 in 2026?

About $193.39 non-facility ($54.78 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 (1.07) and malpractice RVU stay fixed; only practice expense changes (4.56 office vs 0.41 facility). That is the entire office-vs-facility payment gap.