Trends in Medicare Office-Based Procedures for Chronic Rhinitis and Nasal Obstruction

To examine national trends in Medicare office-based procedures for chronic rhinitis and nasal obstruction, emphasizing minimally invasive interventions such as posterior nasal nerve (PNN) ablation and nasal valve repair with radiofrequency ablation.

Retrospective longitudinal analysis of Medicare physician and provider utilization data from 2017 to 2023.

Office-based procedural care across the United States.

Current Procedural Terminology (CPT) codes 30117 (destruction of intranasal lesion), 30140 (inferior turbinate submucous resection), 31295 (maxillary balloon dilation), and 30802 (radiofrequency inferior turbinate reduction) were analyzed, focusing on office-based procedures. CPT 30117 served as a surrogate for PNN ablation and nasal valve repair using radiofrequency ablation. Annual service counts, beneficiaries, Medicare payments, total spending, provider-level adoption, geographic distribution, and early adopter patterns were analyzed. Linear regression evaluated trends over time (P < .05).

From 2017 to 2023, CPT 30117 services rose from 1009 to 11,409 (compound annual growth rate [CAGR] 49.8%), 30140 increased from 3218 to 5792 (CAGR 10.3%), 31295 slightly declined (10,3120 → 9180; CAGR -1.9%), and 30802 declined from 1353 to 863 (CAGR -7.2%). Spending grew sharply for 30117 ($0.41M → $5.08M; +1139%) and 31295 ($12.36M → $15.4M; +25%), modestly for 30140 ($0.89M → $1.05M; +18%), and declined for 30802 ($0.19M → $0.10M; -47%). Texas, Florida, and Arizona had concentrated utilization.

In-office use of CPT 30117 has grown rapidly, outpacing other nasal procedures, reflecting the adoption of new PNN ablation and nasal airway remodeling devices. These trends underscore the need for ongoing evidence development, with further clarification anticipated following new device and procedure-specific coding.