CPT 31242 Surgery - Respiratory
Nsl/sinus ndsc rf abltj pnn Cost
Body System: Respiratory
Medicare Facility Rate
$135
CMS PFS CY2026
Medicare Non-Facility Rate
$2,396
Office/clinic setting
Hospital Outpatient
$6
OPPS rate
Surgery Center (ASC)
$4
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.63
Work RVU
1.02
Facility PE RVU
0.39
Malpractice RVU
71.72
Total RVU
Frequently Asked Questions
How much does Nsl/sinus ndsc rf abltj pnn cost?
The Medicare facility rate is $135. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $6. Ambulatory surgery center rate: $4.
How much does Nsl/sinus ndsc rf abltj pnn cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $135.