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CPT 31225 Fee Schedule

Last Verified: February 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.

Maxillectomy Wo Orbit Exenteration
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Respiratory System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 31225

National average reimbursement for CPT 31225 by major payers:

bcbs

$2,493.53

uhc

$2,364.57

aetna

$2,636.20

cigna

$2,981.68

Preview provider-level rates for...
For billing codeCPT 31225
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 31225

United
31225$565.001689195786 - SOUTHEAST ATLANTA VASCULAR CARE, LLC820825656 - (GA) SOUTHEAST ATLANTA VASCULAR CARE LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$7400.001205939345 - BELTWAY SURGERY CENTERS LLC, INDIANA HAND TO SHOULDER BELTWAY SURGERY CENTER352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$430.001346386604 - DIGESTIVE HEALTH CENTER LLC341955920 - DIGESTIVE HEALTH CENTER, LTD.OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$1456.001023218500 - SAN MARTIN SURGERY CENTER LLC202999408 - (NV) SAN MARTIN SURGERY CENTER LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$670.001730409400 - EYE BONE, LLC, CHARDON SURGERY CENTER204691851 - (OH) EYE BONE, LLC DBA CHARDON SURGERY CENTEROHAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$2732.001871557652 - PORT ST LUCIE SURGERY CENTER LTD621600419 - (FL) PORT ST LUCIE SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$435.001700876703 - RIVERSIDE SURGERY CENTER INC593599967 - (FL) RIVERSIDE SURGERY CENTER INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$105.001811228083 - MESQUITE SURGERY CENTER LLC270170010 - (AZ) MESQUITE SURGERY CENTER, LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$507.001740776517 - TAKLE EYE SURGERY CENTER LLC823838597 - (GA) TAKLE EYE SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$1231.001114975794 - GROSSMONT SURGERY CENTER, L.P.330749339 - (CA) GROSSMONT SURGERY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$1028.001871594275 - DESTIN SURGERY CENTER LLC593723179 - (FL) DESTIN SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$1487.661760761613 - DIERDRE PAYNE350593390 - DEACONESS HOSPITAL INCAZCertified Registered Nurse Anesthetist (367500000X)
United
31225$3237.851295049377 - AHMED JAWAD350593390 - DEACONESS HOSPITAL INCINPulmonary Disease Physician (207RP1001X)
United
31225$7400.001679892913 - BELTWAY SURGERY CENTERS, L.L.C.352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
31225$500.001124277058 - DIGESTIVE HEALTHCARE OF GEORGIA ENDOSCOPY CENTER MOUNTAINSIDE582406657GAAmbulatory 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 31225 vs. Other Surgical Procedures on the Respiratory System Codes

The CPT 31225 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 31225 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
31032-CPTModerateSinusotomy Maxilla Radical W/Removal Pol
31225-CPTHighMaxillectomy Wo Orbit Exenteration
31230-CPTHighMaxillectomy W Orbital Exenteration En
31231-CPTModerateNasal Endoscopy Diagnostic Unilateral Bilateral

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 31225 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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