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See a sample rate comparisonCPT 31238 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery For Chronic Nosebleeds, Surgery To Cut One Or More Arteries At Either The Front Or Back Of The Nose. The Procedure May Be Aided By A Scope (Endoscope).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31238 |
| Medicaid Fee Schedule | View Medicaid rates for 31238 |
National average reimbursement for CPT 31238 by major payers:
$347.13
$361.39
$392.40
$429.84
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CPT 31238
5 of 25 sample ratesHigher to lower in this preview
Medical City Specialty Surgicenter Of Dallas, LLC, Medical City Orthopedic & Spine Surgery Center Dallas
Medical City Specialty Surgicenter Of Dallas LLC
$7,690.00Published ratePremier Eye Surgery Center Of Colorado, LLC, Premier Eye Surgery Center
Premier Eye Surgery Center Of Colorado, LLC
$1,114.00Published rateChesterfield Asc, LLC
$745.00Published rateMoothedath A Menon, Wika Endoscopy Center
M.A. Menon, M.D.
$525.00Published rateThe Surgery Center Of The Villages, LLC, The Surgery Center Of The Villages
The Surgery Center Of The Villages LLC
$340.00Published rate
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See a sample payer proposalCPT 31238 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31238 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 31238 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 |
|---|---|---|
| 31231-CPT | Moderate | Nasal Endoscopy Diagnos Unilat Or Bilate (Sepa Proc, Nasal Endoscopy Diagnostic Unilateral Or Bilateral (Separate Procedu |
| 31233-CPT | Moderate | Nsl/Sins Ndsc Dx Max Sinusc, Nasal/Sinus Endoscopy Diagnostic; With Maxillary Sinusoscopy (Via Inferior Meatus Or Canine Fossa Puncture) |
| 31237-CPT | Moderate | Scope Surgery Of Nose Or Sinus, Nose Or Sinus Surgery Aided By A Scope (Endoscopy). The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy) Removing Excess Tissue Or Cleaning Out The Area. |
| 31238-CPT | Moderate | Surgery For Chronic Nosebleeds, Surgery To Cut One Or More Arteries At Either The Front Or Back Of The Nose. The Procedure May Be Aided By A Scope (Endoscope). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31238. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31238 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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