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See a sample rate comparisonCPT 31200 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.
Removal Of Sinus Tissue, Surgery To Remove Tissue From The Sinus Between The Eye And Nose (Ethmoid Sinus). The Procedure Is Done To Enable The Sinus To Drain Properly.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31200 |
| Medicaid Fee Schedule | View Medicaid rates for 31200 |
National average reimbursement for CPT 31200 by major payers:
$820.72
$751.15
$812.30
$987.57
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CPT 31200
5 of 25 sample ratesHigher to lower in this preview
Meridian Medical Group PC, Meridian Endoscopy Center
$11,291.00Published rateRaymond Renaissance Surgery Center LLC
Raymond Renaissance Surgery Ce
$2,978.00Published rateDeer Creek Surgery Center, LLC
$2,255.00Published rateShenandoah Tx Endoscopy Asc LLC, Woodlands Endoscopy Center
$1,124.00Published rateKendra Streicher
Deaconess Hospital Inc
$476.25Published rate
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See a sample payer proposalCPT 31200 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31200 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 31200 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 |
|---|---|---|
| 31200-CPT | Moderate | Removal Of Sinus Tissue, Surgery To Remove Tissue From The Sinus Between The Eye And Nose (Ethmoid Sinus). The Procedure Is Done To Enable The Sinus To Drain Properly. |
| 31201-CPT | High | Removal Of Sinus Tissue, Surgery To Remove Tissue From The Sinus Between The Eye And Nose (Ethmoid Sinus). The Procedure Is Done To Enable The Sinus To Drain Properly. |
| 31253-CPT | Moderate | Nasalsinus Endoscopy Surgica, Nasalsinus Endoscopy Surgical With Ethmoidectomy Total (Anterior And Posterior) Including Frontal Sinus Exploration With Removal Of Tissue From Frontal Sinus When Performed Imary Procedure) Tery Disease Data Preparation And Transmission A |
| 31254-CPT | Moderate | Nose Or Sinus Surgery, Nose Or Sinus Surgery Aided By A Scope (Endoscopy) To Improve Drainage From The Sinus Between The Eye And Nose (Ethmoid Sinus). The Procedure May Remove Excess Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31200 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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