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See a sample rate comparisonCPT 31020 Fee Schedule
Last Verified: October 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.
Surgery For Sinus Drainage, Surgery To Create An Opening Into The Sinuses To Allow Normal Drainage. The Procedure Can Involve Removing Excess Sinus Tissue Or Polyps. A Thin Tube (Catheter) May Be Inserted After Surgery For A Short Time.
| Key Fact | Detail |
|---|---|
| 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 Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31020 |
| Medicaid Fee Schedule | View Medicaid rates for 31020 |
National average reimbursement for CPT 31020 by major payers:
$595.38
$606.52
$626.34
$581.02
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CPT 31020
5 of 25 sample ratesHigher to lower in this preview
Surgery Affiliate Of El Paso, LLC, Foundation Surgery Affiliate Of El Paso, LLC
Surgery Affiliate Of El Paso LLC
$8,791.00Published rateSugar Land Surgery Center Ltd
$2,713.00Published rateWalla Walla Clinic, Inc., Walla Walla Clinic Ambulatory Surgery Center
Walla Walla Clinic, Inc.
$1,831.00Published rateNephrology Vascular Lab Of Central Alabama Asc LLC
$1,200.00Published rateLive Oak Endoscopy Center, LLC
Live Oak Endoscopy Center
$440.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 31000-CPT | Moderate | Flush Infection Out Of Sinuses, Procedure To Flush An Infection Out Of The Sinuses With A Saltwater (Saline) Solution Using A Needle Inserted Either Under The Lip Or Through The Nose. |
| 31002-CPT | Moderate | Flush Infection Out Of Sinuses, Procedure To Flush An Infection Out Of The Sinuses With A Saltwater (Saline) Solution Using A Needle Inserted Either Under The Lip Or Through The Nose. |
| 31020-CPT | Moderate | Surgery For Sinus Drainage, Surgery To Create An Opening Into The Sinuses To Allow Normal Drainage. The Procedure Can Involve Removing Excess Sinus Tissue Or Polyps. A Thin Tube (Catheter) May Be Inserted After Surgery For A Short Time. |
| 31030-CPT | Moderate | Surgery For Sinus Drainage, Surgery To Create An Opening Into The Sinuses To Allow Normal Drainage. The Procedure Can Involve Removing Excess Sinus Tissue Or Polyps. A Thin Tube (Catheter) May Be Inserted After Surgery For A Short Time. |
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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