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See a sample rate comparisonCPT 31291 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31291 |
| Medicaid Fee Schedule | View Medicaid rates for 31291 |
National average reimbursement for CPT 31291 by major payers:
$1,713.94
$1,621.06
$1,717.38
$1,974.61
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CPT 31291
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Stephenville
$9,124.00Published rateCenter For Pain Management LLC, Tucson Urologic Surgery Center
Center For Pain Management LLC
$1,477.00Published rateSurgical Associates Endoscopy Clinic LLC, Avera Endoscopy/Surgical Center
Surgical Associates Endoscopy Clinic LLC
$900.00Published rateBernstein Hilliker Hartzell Eye Center LLP, The Surgery Center Of Central PA
The Eye Center Of Central PA, LLP
$528.00Published rateWillow Springs Surgery Center, Ltd, Forest Med-Surg Center
Willow Springs Surgery Center Ltd
$162.00Published rate
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See a sample payer proposalCPT 31291 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31291 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 31291 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. |
| 31298-CPT | High | Nasalsinus Endoscopy Surgica, Nasalsinus Endoscopy Surgical With Dilation Of Frontal And Sphenoid Sinus Ostia (Eg Balloon Dilation) Imary Procedure) Tery Disease Data Preparation And Transmission A |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31291 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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