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See a sample rate comparisonCPT 31240 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.
Nasal/Sinus Endoscopy, Surgical; W/Biopsy, Polypectomy Or Debridement (Separate Procedure) With Concha Bullosa Resection
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31240 |
| Medicaid Fee Schedule | View Medicaid rates for 31240 |
National average reimbursement for CPT 31240 by major payers:
$214.19
$213.41
$232.38
$262.73
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CPT 31240
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Memorial City LLC, Memorial Hermann Memorial Village Surgery Center
$5,729.00Published rateDigestivecare, LLC, Digestivecare Endoscopy Unit
Digestive Care, Inc.
$2,353.00Published rateParamount Surgery Center, LLC, The Center For Specialized Surgery
Paramount Surgery Center LLC
$1,778.00Published rateAmerican Access Care Of Pennsylvania Asc LLC
$1,200.00Published rateSt George Endoscopy Center LLC, St. George Endoscopy Center
St George Endoscopy Center LLC
$700.00Published rate
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See a sample payer proposalCPT 31240 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31240 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 31240 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. |
| 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). |
| 31240-CPT | Moderate | Nasal/Sinus Endoscopy, Surgical; W/Biopsy, Polypectomy Or Debridement (Separate Procedure) With Concha Bullosa Resection |
| 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31240 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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