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See a sample rate comparisonCPT 31298 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.
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
| 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 LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31298 |
| Medicaid Fee Schedule | View Medicaid rates for 31298 |
National average reimbursement for CPT 31298 by major payers:
$3,806.31
$4,884.47
$4,699.19
$5,506.78
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CPT 31298
5 of 25 sample ratesHigher to lower in this preview
Elko Community Health Center, LLC
Elko Community Health Center LLC
$8,689.00Published rateAsc Of Trinity, Comprehensive Outpatient Joint And Spine Institute
Asc Of Trinity
$3,500.00Published rateOphthalmology Ltd Eye Surgery Center LLC
Ophthalmology, Ltd Eye Surgery Center
$2,100.00Published rateKuresmart Pain Management Surgery Center, Clearway Surgery Center Of Dundalk
Kuresmart Pain Management Surgery Center
$1,334.00Published rateCandescent Eye Surgicenter LLC
$711.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 31298 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31298 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 31298 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 31298. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31298 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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