Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 31276 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.
Sinus Surgery With Scope, Surgery Aided By A Scope (Endoscopy) To Explore The Sinus In The Forehead. The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy).
| 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 50 - Bilateral Procedure LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31276 |
| Medicaid Fee Schedule | View Medicaid rates for 31276 |
National average reimbursement for CPT 31276 by major payers:
$563.88
$584.62
$625.27
$679.35
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 31276.
CPT 31276
5 of 25 sample ratesHigher to lower in this preview
Cumberland Surgical Hospital Of San Antonio LLC, Legent Orthopedic & Spine
$12,033.91Published rateProvidence Health & Services, Pmg Nw Wa Marysville Clinic
$1,091.78Published rateMaya Sardesai
$783.05Published rateTimothy Talbert
Highland Clinic, Apmc
$654.42Published rateKindl Works LLC
$340.98Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 31276 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31276 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 31276 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 |
|---|---|---|
| 31070-CPT | Moderate | Drain Front Nasal Sinus, Surgery To Drain The Frontal Sinus (Between The Eyebrows). Catheters (Thin Tubes) Are Temporarily Placed To Rinse The Sinus With Saltwater (Saline). |
| 31084-CPT | High | Sinusotomy Frontal Obliterati, Sinusotomy Frontal Obliterative With Osteoplastic Flapbrow Incision Sinusotomy Frontal Obliterative With Osteoplastic Flap |
| 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. |
| 31276-CPT | Moderate | Sinus Surgery With Scope, Surgery Aided By A Scope (Endoscopy) To Explore The Sinus In The Forehead. The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31276. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31276 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 31276) and we'll show you how you compare in 15 minutes or less.