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See a sample rate comparisonCPT 31075 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Removal Of Sinus Tissue, Surgery To Removed Diseased Tissue From The Frontal Sinus (Between The Eyebrows) And If Necessary From The Ethmoid Sinus (Between The Nose And Eye). An Opening For Drainage To The Nose May Be Created.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31075 |
| Medicaid Fee Schedule | View Medicaid rates for 31075 |
National average reimbursement for CPT 31075 by major payers:
$1,080.63
$1,033.48
$1,112.18
$1,324.35
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CPT 31075
5 of 25 sample ratesHigher to lower in this preview
The Emory Clinic Inc, Emory Ambulatory Surgery Center At Spivey Station
Emory University
$7,635.00Published rateGardendale Surgical Associates, LLC
Gardendale Surgical Associates
$4,781.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$2,693.00Published rateMiami Asc Lp, The Endoscopy Center
Miami Asc Lp
$1,579.00Published rateSpalding Endoscopy Center, LLC
Spalding Endoscopy Center LLC
$700.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 31075 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31075 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 31075 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 |
|---|---|---|
| 31070-CPT | Moderate | Drain Front Nasal Sinus, Surgery To Drain The Frontal Sinus (Between The Eyebrows). Catheters (Thin Tubes) Are Temporarily Placed To Rinse The Sinus With Saltwater (Saline). |
| 31075-CPT | High | Removal Of Sinus Tissue, Surgery To Removed Diseased Tissue From The Frontal Sinus (Between The Eyebrows) And If Necessary From The Ethmoid Sinus (Between The Nose And Eye). An Opening For Drainage To The Nose May Be Created. |
| 31080-CPT | High | Sinusotomy Frontal Obliterati, Sinusotomy Frontal Obliterative Without Osteoplastic Flap Brow Incision (Includes Ablation) Sinusotomy Frontal Obliterative Without Osteoplastic Flap |
| 31084-CPT | High | Sinusotomy Frontal Obliterati, Sinusotomy Frontal Obliterative With Osteoplastic Flapbrow Incision Sinusotomy Frontal Obliterative With Osteoplastic Flap |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31075. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31075 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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