CPT 31050 Fee Schedule
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.
| 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 • LT - Left side of body • 50 - Bilateral Procedure |
| Complexity Level | Moderate |
National average reimbursement for CPT 31050 by major payers:
$659.72
$641.08
$681.44
$844.42
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 31050 | ||||||
United | 31050 | $3792.00 | 1508304692 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $5433.00 | 1831420694 - TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC | 263531997 - (FL) TITUSVILLE CENTER FOR SURGICAL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $1017.00 | 1417904756 - METROPOLITAN MEDICAL CENTER, LLC | 202804280 - (WI) METROPOLITAN MEDICAL CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $5433.00 | 1538126362 - WINTER HAVEN AMBULATORY SURGICAL CENTER LLC | 593659906 - (FL) WINTER HAVEN AMBULATORY SURGICAL CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $3400.00 | 1205171295 - VANCE THOMPSON VISION SURGERY CENTER PROF LLC, VANCE THOMPSON VISION SURGERY CENTER | 455323939 | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $1203.00 | 1538110713 - CENTER FOR DIGESTIVE HEALTH LLC | 201606438 - (MS) CENTER FOR DIGESTIVE HEALTH LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $2101.00 | 1124058946 - LUTHERVILLE SURGICENTER, LLC | 522109473 - (MD) LUTHERVILLE SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $1250.00 | 1578745568 - THE ENDOSCOPY CENTER OF WEST CENTRAL OHIO, LLC | 260251730 - (OH) THE ENDOSCOPY CENTER OF WEST CENTRAL OHIO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $8441.00 | 1871720540 - BALL OUTPATIENT SURGERY CENTER, LLC, BALL OUTPATIENT SURGERY CENTER | 270275794 - (IN) BALL OUTPATIENT SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $1921.00 | 1881276319 - TEXARKANA PAIN SURGERY CENTER LLC | 844941902 - (AR) TEXARKANA PAIN SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $5433.00 | 1598996894 - SURGICAL ELITE OF AVONDALE, LLC | 270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $2693.00 | 1114491073 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $1270.00 | 1700856242 - SOUTHERN OHIO EYE SURGERY CENTER, LLC | 43700734 - (OH) SOUTHERN OHIO EYE SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $3200.00 | 1124395876 - RISSER SURGERY CENTER, LLC | 453644441 - (CA) RISSER SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31050 | $412.00 | 1598093007 - TARBORO ENDOSCOPY CENTER, LLC | 271345858 - (NC) TARBORO ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 31050 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31050 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 31050 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 |
|---|---|---|
| 31050-CPT | Moderate | Sinusotomy, Sphenoid, Withor Without Bi |
| 31051-CPT | Moderate | Sinusotomy Sphenoid W Polypectomy |
| 31235-CPT | Moderate | Nasal/Sinus Endoscopy Diagnostic; With Sphenoid Sinusoscopy (Via Puncture Of Sphenoidal Face Or Cannulation Of Ostium) (Desc Rvsd 1/1/20) |
| 31288-CPT | Moderate | Nasal/Sinus Endoscopy, Surgical, With Sphenoidotomy; With Removal Of Tissue From The 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 31050. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31050 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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