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CPT 31020 Fee Schedule

Last Verified: January 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.

Sinusotomy Maxilla (Antrotomy) Intranasa
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Respiratory System

Common Place of Service

22 - On Campus Outpatient Hospital

11 - Office

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 31020

National average reimbursement for CPT 31020 by major payers:

bcbs

$595.38

uhc

$606.52

aetna

$626.34

cigna

$730.65

Preview provider-level rates for...
For billing codeCPT 31020
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 31020

United
31020$3500.001639146541 - CENTENNIAL ASC, LLC, BAYLOR SURGICARE AT CENTENNIAL352199232 - (TX) CENTENNIAL ASC LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$893.001821397654 - RENUE SURGERY CENTER OF WAYCROSS, LLC273847480 - (GA) RENUE SURGERY CENTER OF WAYCROSS LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$1577.001164852455 - NURA SURGICAL CENTER LLC, MINNEAPOLIS PAIN CENTERS LLC901026241MNAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$1211.001134590912 - SLENT INVESTMENTS, LLC, SLENT SURGERY CENTER472307119 - (LA) SLENT INVESTMENTS LLCLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$1450.001649416231 - CLINTON PARTNERS, LLC, SURGERY CENTER OF CLINTON TOWNSHIP202236024MIAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$4141.001851887863 - TEXAS HEALTH SURGERY CENTER IRVING, LLC831085415TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$2007.001750970869 - BSC CHANDLER LLC853443457 - (AZ) BSC CHANDLER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$3500.001902218456 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY AT INDEPENDENCE MEDICAL VILLAGE470985876TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$3500.001245798826 - SURGCENTER OF GREATER DALLAS, LLC., SURGCENTER OF GREATER DALLAS831498677 - (TX) SURGCENTER OF GREATER DALLAS LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$2713.001659316917 - SUGAR LAND SURGERY CENTER LTD621742196 - (TX) SUGAR LAND SURGERY CENTER LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$767.001922011501 - LOWERY A. WOODALL OUTPATIENT SURGERY FACILITY, LLC640897321MSAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$839.541962784165 - RANA BEG350593390 - DEACONESS HOSPITAL INCFLHospitalist Physician (208M00000X)
United
31020$2206.001437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIELAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$2307.001205023280 - SUMMIT AMBULATORY SURGICAL CENTER, LLC522148280MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
31020$1200.001508360181 - NEPHROLOGY VASCULAR LAB OF CENTRAL ALABAMA ASC LLC815281505 - (AL) NEPHROLOGY VASCULAR LAB OF CENTRAL ALABAMA ASC LLCALAmbulatory 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 31020 vs. Other Surgical Procedures on the Respiratory System Codes

The CPT 31020 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 31020 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
31020-CPTModerateSinusotomy Maxilla (Antrotomy) Intranasa

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 31020 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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