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See a sample rate comparisonCPT 31294 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.
Relieve Optic Nerve Pressure, Surgery Aided By A Scope (Endoscopy) To Relieve Pressure On A Major Nerve In The Eye (Optic Nerve). The Procedure Shaves Bone That Is Pressing On The Nerve.
| 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 50 - Bilateral Procedure LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31294 |
| Medicaid Fee Schedule | View Medicaid rates for 31294 |
National average reimbursement for CPT 31294 by major payers:
$1,606.12
$1,639.13
$1,701.74
$2,002.08
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CPT 31294
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$10,099.00Published rateDoctors Outpatient Surgery Center Of Jupiter, LLC, Laser & Surgery Center Of The Palm Beaches
Drs. Outpatient Surgery Center Of Jupiter, LLC
$3,347.00Published rateValley Surgical Center Ltd, Valley Surgery Center
Valley Surgical Center Ltd
$1,984.00Published rateDmg Pain Management Surgery Center, LLC
Dmg Pain Management Surgery Center LLC
$1,375.00Published ratePatrick A Conarro Md, D.B.A. Summit Surgical Asc
Patrick A Conarro Md
$613.00Published rate
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See a sample payer proposalCPT 31294 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31294 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 31294 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 |
|---|---|---|
| 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. |
| 31294-CPT | High | Relieve Optic Nerve Pressure, Surgery Aided By A Scope (Endoscopy) To Relieve Pressure On A Major Nerve In The Eye (Optic Nerve). The Procedure Shaves Bone That Is Pressing On The Nerve. |
| 31297-CPT | High | Nasal/Sinus Endoscopy, Surgical, With Dilation; Sphenoid Sinus Ostium - Rn Review>=3/7/2018; Deny Inv/N10=1/1/2011-3/6/2018 Except Uhs & City Of Knoxville |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31294. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31294 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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