CPT 31256 Surgery - Respiratory
Exploration maxillary sinus Cost
Body System: Respiratory
Medicare Facility Rate
$153
CMS PFS CY2026
Medicare Non-Facility Rate
$153
Office/clinic setting
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$1
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
3.03
Work RVU
1.11
Facility PE RVU
0.43
Malpractice RVU
4.57
Total RVU
Frequently Asked Questions
How much does Exploration maxillary sinus cost?
The Medicare facility rate is $153. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $3. Ambulatory surgery center rate: $1.
How much does Exploration maxillary sinus 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 $153.