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CPT 31000 Fee Schedule

Last Verified: March 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Lavage By Cannulation; Maxill.Sinus
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Respiratory System

Common Place of Service

11 - Office

24 - Ambulatory Surgical Center

Common Modifiers

None

50 - Bilateral Procedure

59 - Distinct Procedural Service

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 31000

National average reimbursement for CPT 31000 by major payers:

bcbs

$226.44

uhc

$230.83

aetna

$246.04

cigna

$303.20

Preview provider-level rates for...
For billing codeCPT 31000
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 31000

United
31000$245.001346469731 - AKDHC SURGERY CENTER, LLC753052504AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$531.001932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE821568426AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$80.001124296173 - TREASURE COAST SURGICAL CENTER INC260770428 - (FL) TREASURE COAST SURGICAL CENTER, INC.FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$347.001366411829 - SUMMIT SURGERY CENTER, L.P., DR. ROY A. HIMELFARB SURGERY CENTER251845303 - (PA) SUMMIT SURGERY CENTER LPPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$230.001922660109 - BANNER SURGERY CENTER842157389 - (AZ) BANNER SURGERY CENTERAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$531.001124125604 - MURDOCK AMBULATORY SURGERY CENTER LLC201543128 - (FL) MURDOCK AMBULATORY SURGERY CENTEFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$88.001255404398 - WARMINSTER AMBULATORY SURGICAL, BUXMONT AMBULATORY SURGICAL CENTER232779763 - (PA) WARMINSTER AMBULATORY SURGICALPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$225.001154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE871712552 - (AZ) BSC 3 LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$555.001861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$79.001154555472 - GEORGIA RETINA SURGERY CENTER, LLC262303683 - (GA) GEORGIA RETINA SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$178.001750927190 - HERMITAGE ENDOSCOPY CENTER INC841815468 - (PA) HERMITAGE ENDOSCOPY CENTER INCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$129.001417362831 - J. GRAFF SURGERY CENTER INC, WILLOW BEND SURGERY CENTER OF PLANO463194833 - (TX) J GRAFF SURGERY CENTER INCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$110.001780658062 - GLEN ENDOSCOPY CENTER, LLC364486546 - (IL) THE GLEN ENDOSCOPY CENTER, LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$265.001770532194 - BROADWEST SPECIALTY SURGICAL CENTER, LLC710991736 - (IN) BROADWEST SPECIALTY SURGICAL 401INAmbulatory Surgical Clinic/Center (261QA1903X)
United
31000$128.001750362869 - EYE HEALTH EASTSIDE SURGERY CENTER680568557 - (OR) EYE HEALTH EASTSIDE SURGERY CENTERORAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 31000 vs. Other Surgical Procedures on the Respiratory System Codes

The CPT 31000 code is part of the Surgery services used for Surgical Procedures on the Respiratory System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 31000 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
30120-CPTModerateExc/Surg Plane-Nose Skin-Rhinophyma
30200-CPTLowInjection Into Turbinate(S), Therapeutic
31000-CPTModerateLavage By Cannulation; Maxill.Sinus
31002-CPTModerateLavage-Cannulation;Sphenoid Sinus

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 31000 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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