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CPT 31201 Fee Schedule

Last Verified: December 2025

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.

Ethmoidectomy Intranasal Total
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Respiratory System

Common Place of Service

22 - On Campus Outpatient Hospital

24 - Ambulatory Surgical Center

Common Modifiers

None

50 - Bilateral Procedure

LT - Left side of body

Complexity LevelHigh

National average reimbursement for CPT 31201 by major payers:

bcbs

$1,036.10

uhc

$981.43

aetna

$1,057.54

cigna

$1,277.38

Preview provider-level rates for...
For billing codeCPT 31201
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 31201

United
31201$1233.001528077658 - PRINCE WILLIAM AMBULATORY SURGERY CENTER, LLC, PRINCE WILLIAM SURGERY CENTER770594498 - (VA) PRINCE WILLIAM AMBULATORYVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$1666.001962568543 - ENDOSCOPY CENTER OF OCEAN COUNTY, LLC223461117 - (NJ) ENDOSCOPY CENTER OF OCEAN COUNTY, PCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$682.001336112200 - MERCER COUNTY SURGERY CENTER LLC, MERCER COUNTY SURGERY CENTER223774069 - (NJ) MERCER COUNTY SURGERY CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$1278.001992713010 - NORTHFIELD SURGICAL CENTER LLC, NORTHFIELD SURGICAL CENTER223509801 - (NJ) NORTHFIELD SURGICAL CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$525.001801827993 - SOUTH CAROLINA ENDOSCOPY CENTER571125931 - (SC) SOUTH CAROLINA ENDOSCOPY CENTERSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$1115.001275178444 - KENOSHA DIGESTIVE HEALTH CENTER LLC842167873 - (WI) KENOSHA DIGESTIVE HEALTH CENTER LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$840.001386821817 - MIAMI SURGERY CENTER LLC, SURGERY CENTER AT DORAL364600281 - (FL) MIAMI SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$995.001467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTDILAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$625.001942540851 - THE ORTHOPAEDIC AND SPINE CENTER OF SOUTHERN COLORADO, LLC461852637 - (CO) THE ORTHOPAEDIC & SPINE CENTER OF S COLORADOCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$950.001144652330 - UNIVERSITY SURGERY CENTER LLC, MALLARD CREEK SURGERY CENTER462574454 - (NC) UNIVERSITY SURGERY CENTER LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$1020.001245806876 - WICHITA UROLOGY SURGERY CENTER,LLC834482229 - (KS) WICHITA UROLOGY SURGERY CENTERLLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$1075.001841255718 - PAOLI SURGERY CENTER LLC621547618 - (PA) PAOLI SURGERY CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$947.001770008922 - BANNER PHOENIX SURGERY CENTER LLC901182683AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$538.001508531740 - BAY AREA HEART SURGERY CENTER852782496 - (FL) BAY AREA HEART SURGERY CENTERFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31201$827.001093779951 - EYE SURGERY AND LASER CLINIC, INC.562172461 - (NC) EYE SURGERY AND LASER CLINIC INCNCAmbulatory 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 31201 vs. Other Surgical Procedures on the Respiratory System Codes

The CPT 31201 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 31201 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
31200-CPTModerateEthmoidectomy Intranasal Anterior
31201-CPTHighEthmoidectomy Intranasal Total
31205-CPTHighEthmoidectomy Extranasal Total
31254-CPTModerateNasal/Sinus Endoscopy Surgical With Ethmoidectomy; Partial (Anterior) (Desc Revised 1/1/2018)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31201. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 31201 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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