CPT 31239 Surgery - Respiratory

How Much Does Nsl/sinus Endoscopy Surgical Dcr Cost?

Also known as: Nsl/sinus endoscopy surg dcr (CPT 31239)

Nsl/sinus Endoscopy Surgical Dcr (CPT 31239) costs $525 at Medicare rates. Hospital outpatient rate: $3.

Cost Comparison by Payer

How much Nsl/sinus endoscopy surg dcr costs across different settings and payers

Medicare
Facility rate
$525
Hospital Outpatient
OPPS rate
$3
Surgery Center
ASC rate
$1
Medicare (Facility)
$525
CMS PFS 2026 national rate
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$1
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside Nsl/sinus endoscopy surg dcr

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How to Reduce Your Cost for Nsl/sinus endoscopy surg dcr

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $1, compared to $3 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

8.81
Work RVU
5.91
Practice Expense RVU
0.99
Malpractice RVU
15.71
Total RVU

Payment = Total RVU (15.71) x CF ($33.40) = $525

Frequently Asked Questions

How much does Nsl/sinus endoscopy surg dcr cost?

The Medicare facility rate for Nsl/sinus endoscopy surg dcr is $525. In a hospital outpatient setting, the rate is $3. At an ambulatory surgery center, the rate is $1. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Nsl/sinus endoscopy surg dcr cost without insurance?

Without insurance, the cost of Nsl/sinus endoscopy surg dcr can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Nsl/sinus endoscopy surg dcr?

Most commercial health insurance plans and Medicare cover Nsl/sinus endoscopy surg dcr when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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