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 31297 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 50 - Bilateral Procedure RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31297 |
| Medicaid Fee Schedule | View Medicaid rates for 31297 |
National average reimbursement for CPT 31297 by major payers:
$2,909.30
$3,249.91
$2,965.33
$3,153.92
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 31297.
CPT 31297
5 of 25 sample ratesHigher to lower in this preview
Carolina Regional Surgery Center. Ltd
Carolina Regional Surgery Center Ltd
$6,133.00Published rateThomas Green
Deaconess Hospital Inc
$3,384.62Published rateVance Thompson Vision Surgery Center Billings, LLC
$2,300.00Published rateCenter For Pain Management Ambulatory Surgery, Ltd
Center For Pain Management Ambulatory Surgery Ltd
$1,530.00Published rateTranssouth Health Care PLLC, Transsouth Health Care PC
Transsouth Health Care, P.C.
$520.00Published 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 31297 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31297 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 31297 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 |
|---|---|---|
| 31295-CPT | High | Nasal/Sinus Endoscopy, Surgical, With Dilation; Maxillary Sinus Ostium - Rn Review>=3/7/2018; Deny Inv/N10=1/1/2011-3/6/2018 Except Uhs & City Of Knoxville |
| 31296-CPT | High | Nasal/Sinus Endoscopy, Surgical, With Dilation; Frontal Sinus Ostium - Rn Review>=3/7/2018; Deny Inv/N10=1/1/2011-3/6/2018 Except Uhs & City Of Knoxville |
| 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 |
| 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 31297. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31297 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 31297) and we'll show you how you compare in 15 minutes or less.