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See a sample rate comparisonCPT 31290 Fee Schedule
Last Verified: October 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.
Repair Of Spinal Fluid Leak, Nose Surgery Aided By A Scope (Endoscopy) To Repair A Leak That Allows Spinal Fluid Into The Sinuses Around The Eye.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31290 |
| Medicaid Fee Schedule | View Medicaid rates for 31290 |
National average reimbursement for CPT 31290 by major payers:
$1,495.26
$1,522.77
$1,609.61
$1,863.01
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CPT 31290
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Memorial City LLC, Memorial Hermann Memorial Village Surgery Center
$5,554.00Published rateAdventhealth Surgery Center Davenport LLC
$1,049.00Published rateGeorgia Urology, PA
$725.00Published rateNovamed Surgery Center Of Cleveland LLC, The Surgery Center Of Cleveland
Novamed Surgery Center Of Cleveland LLC
$400.00Published rateEyes Of York Surgical Center LLC
$150.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 31290 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31290 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 31290 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 |
|---|---|---|
| 31290-CPT | High | Repair Of Spinal Fluid Leak, Nose Surgery Aided By A Scope (Endoscopy) To Repair A Leak That Allows Spinal Fluid Into The Sinuses Around The Eye. |
| 31291-CPT | High | Repair Of Spinal Fluid Leak, Nose Surgery Aided By A Scope (Endoscopy) To Repair A Leak That Allows Spinal Fluid Into The Sinuses Around The Eye. |
| 31292-CPT | High | Surgery For Eye Pressure, Surgery Aided By A Scope (Endoscopy) To Relieve Pressure On The Eye. A Small Hole Is Made In The Eye Socket To Give The Eye More Room. |
| 31293-CPT | High | Surgery For Eye Pressure, Surgery Aided By A Scope (Endoscopy) To Relieve Pressure On The Eye. A Small Hole Is Made In The Eye Socket To Give The Eye More Room. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31290. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31290 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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