{
    "code": "31237",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/31237/2021/A",
    "release_specific_url": "https://localishealth.com/cpt/31237/2021/A",
    "description": "A surgical endoscopic exam of the nose and sinuses, using a thin scope passed through the nostril, combined with biopsy, polyp removal, or debridement of tissue and debris.",
    "answer": {
        "question": "How much did Medicare pay for CPT 31237 in Q1 2021?",
        "text": "Medicare paid $262.40 for CPT 31237 in the office (non-facility) setting and $160.86 in a facility under the Q1 2021 Physician Fee Schedule, effective January 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.8% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "A",
        "label": "Q1 2021",
        "effective": "January 1 – March 31, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 262.4,
        "facility": 160.86,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 2.6,
        "practice_expense_non_facility": 4.56,
        "practice_expense_facility": 1.65,
        "malpractice": 0.36
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q1 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21a-updated-01052021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/A",
        "file": "PPRRVU21_JAN.csv",
        "row": 7972,
        "sha256": "8e6212d64ca58c6a20c44ea319d2148c49156b1fe63a6b68e64a5b0695b0e674"
    },
    "modified_at": "2026-08-04T03:10:16+00:00"
}