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See a sample rate comparisonCPT 31201 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 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 | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None 50 - Bilateral Procedure LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31201 |
| Medicaid Fee Schedule | View Medicaid rates for 31201 |
National average reimbursement for CPT 31201 by major payers:
$1,036.10
$981.43
$1,057.54
$1,256.25
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CPT 31201
5 of 25 sample ratesHigher to lower in this preview
North Austin Surgery Center, L.P.
North Austin Surgery Center Lp
$2,782.00Published rateSurgcenter Of Greater Jacksonville, LLC
Surgcenter Of Greater Jacksonville LLC
$1,179.00Published rateCreve Coeur Surgery Center, LLC, City Place Surgery Center
Creve Coeur Surgery Center LLC
$832.00Published rateThe Orthopaedic And Spine Center Of Southern Colorado, LLC
The Orthopaedic & Spine Center Of S Colorado
$625.00Published rateZion Ambulatory Center LLC
$396.00Published rate
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See a sample payer proposalCPT 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.
| 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. |
| 31205-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. |
| 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 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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