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See a sample rate comparisonCPT 31205 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 | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31205 |
| Medicaid Fee Schedule | View Medicaid rates for 31205 |
National average reimbursement for CPT 31205 by major payers:
$1,276.91
$1,177.57
$1,256.43
$1,506.87
Compare published rates across providers.
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CPT 31205
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Pinecroft, LLC
Memorial Hermann Surgery Center Pinecroft LLC
$5,048.00Published rateHagerstown Surgery Center,LLC
Hagerstown Surgery Center, LLC
$2,101.00Published rateSouthwestern Eye Center, Southwestern Eye Surgicenter-Show Low
Southwestern Eye Center, Ltd.
$1,505.00Published ratePodiatry Associates Ambulatory Surgical Centers LLC
$734.00Published rateBetter Living Endoscopy Center
$525.00Published rate
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See a sample payer proposalCPT 31205 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31205 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 31205 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. |
| 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31205. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31205 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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