31040

Active90-day global

Exploration behind upper jaw

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number.

Locality

or ZIP

Show values as

Modifiers

Line	Qty	Non-facility (office)	Facility (hospital/ASC)
31040Exploration behind upper jaw	1	$721.79	$721.79

Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCI_w + PE×GPCI_pe + MP×GPCI_mp) × CF

Row	Work RVU	PE RVU (office)	PE RVU (facility)	MP RVU	Total (office)
31040	9.53	10.65	10.65	1.43	21.61

Payment policy for 31040

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=0

Physician service

Cannot be split into professional/technical components — modifiers 26 and TC don't apply.

Multiple procedures

mult_surg=2

Standard MPPR

When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.

Bilateral (modifier 50)

bilt_surg=1

Bilateral 150%

With modifier 50 (both sides), payment is 150% of the single-side amount.

Assistant surgeon (80/81/82)

asst_surg=1

Not payable

Assistant at surgery may not be paid for this procedure.

Co-surgeons (modifier 62)

co_surg=1

Payable with documentation

Co-surgeons paid (62.5% each) if medical necessity is documented.

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Global surgery package

Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 10% is attributed to pre-operative care, 76% to the procedure itself, and 14% to post-operative visits.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.