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See a sample rate comparisonCPT 31239 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 To Repair Tear Duct, Surgery Aided By A Scope (Endoscopy) To Reconstruct Blocked Tear Ducts. The Procedure Creates A New Drainage Pathway From The Eye To The Nose.
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31239 |
| Medicaid Fee Schedule | View Medicaid rates for 31239 |
National average reimbursement for CPT 31239 by major payers:
$853.03
$826.28
$896.31
$1,012.38
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CPT 31239
5 of 25 sample ratesHigher to lower in this preview
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC, Iu Health Surgery Center Fort Wayne
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC
$8,705.00Published rateUniversity Of Minnesota Health Clinics And Surgery Center, Inc, Umhcsc Asc Episodic Bundle
University Of Minnesota Health Clinics And Surgery Center Inc
$3,657.00Published rateNorth Atlanta Ear, Nose & Throat Surgical Center, LLC
North Atlanta Ear Nose Throat Surgical Center LLC
$1,647.00Published rateSurgical Specialty Associates LLC, Doctors Same Day Surgery Center LLC
Surgical Specialty Associates
$1,153.00Published rateOcala Endoscopy Asc Lp, Endoscopy Center Of Ocala
Ocala Endoscopy Asc Lp
$577.00Published rate
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See a sample payer proposalCPT 31239 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31239 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 31239 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 |
|---|---|---|
| 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. |
| 31239-CPT | Moderate | Surgery To Repair Tear Duct, Surgery Aided By A Scope (Endoscopy) To Reconstruct Blocked Tear Ducts. The Procedure Creates A New Drainage Pathway From The Eye To The Nose. |
| 31241-CPT | Moderate | Nose Or Sinus Surgery, Nose Or Sinus Surgery Aided By A Scope (Endoscopy) To Treat Excessive Nose Bleeds. The Procedure Includes Closing Off An Artery In The Nasal Passage. |
| 31256-CPT | Moderate | Scope Surgery Of Nose Or Sinus, Surgery Aided By A Scope (Endoscopy) On The Nose Or Sinus. The Procedure May Include Draining A Sinus Or Removing Abnormal Tissue Such As Polyps. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31239. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31239 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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