31294
Active10-day globalNsl/sins ndsc surg on dcmprn
2026 Medicare payment
Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 31294 | 1 | $1,052.13 | $1,052.13 |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 31294 | 19.80 | 8.80 | 8.80 | 2.90 | 31.50 |
Payment policy for 31294
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=0Physician service
Cannot be split into professional/technical components — modifiers 26 and TC don't apply.
Multiple procedures
mult_surg=3Endoscopy rule
Special multiple-endoscopy rules apply within the same endoscopy family, then standard ranking.
Bilateral (modifier 50)
bilt_surg=1Bilateral 150%
With modifier 50 (both sides), payment is 150% of the single-side amount.
Assistant surgeon (80/81/82)
asst_surg=0Payable with documentation
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Co-surgeons (modifier 62)
co_surg=0Not permitted
Co-surgeons (mod 62) may not be paid for this procedure.
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
Global surgery package
Payment covers the procedure plus related care for 10 days after. Of the total payment, 10% is attributed to pre-operative care, 80% to the procedure itself, and 10% 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.