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31294 Nsl/sinus ndsc surgical on dcmprn

Surgery Global 10d

Also known as: endoscopic unilateral orbital decomp, one-sided orbital surgery, orbital decompression unilateral

Nasal and sinus endoscopic surgery with extensive management on orbital decompression side, often for severe unilateral orbital disease.

In Plain Language

one-sided eye pressure relief surgery

Clinical Context

Endoscopic orbital decompression limited to one side for asymmetric disease. Commonly performed on more severely affected eye.

RVU Breakdown

Work RVU19.80
Total RVU19.80

Est. Medicare Payment

$661.32

National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).

Billing & Documentation

As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 10-day global period — follow-up visits within 10 days of the procedure are included in the reimbursement. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.

How This Code Compares

With a work RVU of 19.80, this code ranks in the 82nd percentile among Surgery codes — 2.5x the median (8.00). The highest wRVU in this category is 106.19.

Specialties

OtolaryngologyRhinologyOrbital Surgery

Frequently Asked Questions

What is CPT code 31294?

CPT 31294 (Nsl/sinus ndsc surgical on dcmprn) is a Surgery code. Nasal and sinus endoscopic surgery with extensive management on orbital decompression side, often for severe unilateral orbital disease.

What is the wRVU value for CPT 31294?

The work RVU for CPT 31294 is 19.80. This code is primarily used by Otolaryngology, Rhinology, Orbital Surgery. It has a 10-day global period.

When is CPT 31294 used?

Endoscopic orbital decompression limited to one side for asymmetric disease. Commonly performed on more severely affected eye.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.