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CPT 31205 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 Extranasal Total
Key FactDetail
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 LevelHigh

National average reimbursement for CPT 31205 by major payers:

bcbs

$1,276.91

uhc

$1,177.57

aetna

$1,256.43

cigna

$1,538.65

Preview provider-level rates for...
For billing codeCPT 31205
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 31205

United
31205$1282.001043680440 - SOUTHWEST MEDICAL ASSOCIATES, INC, SOUTHWEST MEDICAL ASSOCIATES - TENAYA880201420NVAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$1624.181871858514 - RAJASHEKAR KUMAR350593390 - DEACONESS HOSPITAL INCINInternal Medicine Physician (207R00000X)
United
31205$1624.181891182010 - SARAH KUNG350593390 - DEACONESS HOSPITAL INCKYPulmonary Disease Physician (207RP1001X)
United
31205$700.001083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C.MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$2388.001588854772 - ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC201243484 - (AL) ALABAMA DIGESTIVE HEALTHALAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$2353.001689664906 - PEDIATRIC SURGERY CENTERS, LLC201711553FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$1490.001740700111 - M. REZA MIZANI, M.D., P.A., TOTAL VASCULAR CARE200743330 - (TX) M. REZA MIZANI MD, PATXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$622.001942272851 - INDEPENDENCE ASC LLC, THE ENDOSCOPY CENTER - LIBERTY621707564MOAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$1271.001285692004 - TEC NORTH, LLC, THE ENDOSCOPY CENTER NORTH201871076 - (TN) TEC NORTH LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$1375.361518057546 - LONG ISLAND AMBULATORY SURGERY CENTER, LLC200369668 - (NY) LONG ISLAND AMBULATORY SURGERY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$2527.001386161495 - MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC820985178 - (MD) MEDSTAR SURGERY CENTER AT BRANMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$2353.001538773890 - ASC OF TRINITY, COMPREHENSIVE OUTPATIENT JOINT AND SPINE INSTITUTE833008593 - (FL) ASC OF TRINITYFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$1475.001235551052 - LONG ISLAND DIGESTIVE ENDOSCOPY CENTER, LLC454714972NYAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$507.001629133442 - ARIZONA SURGICAL ARTS, INC.860607769 - (AZ) ARIZONA SURGICAL ARTS INCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31205$2353.001629508387 - WELLINGTON ENDOSCOPY CENTER LLC813254698 - (FL) WELLINGTON ENDOSCOPY CENTER LLCFLAmbulatory 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 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.

CodeComplexityDescription
31200-CPTModerateEthmoidectomy Intranasal Anterior
31201-CPTHighEthmoidectomy Intranasal Total
31205-CPTHighEthmoidectomy Extranasal Total
31253-CPTModerateNasal/Sinus Endoscopy, Surgical With Ethmoidectomy; Total (Anterior And Posterior), Including Frontal Sinus Exploration, With Removal Of Tissue From Frontal Sinus, When Performed

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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