CPT
31231 — Nasal endoscopy, diagnostic, unilateral or bilateral
Verify the code matches the actual service and dose.
ENT
31237 — Nasal/sinus endoscopy, surgical; with biopsy, polypectomy, or debridement
The surgeon inserts a thin camera into your nasal passages and sinuses and performs one of three procedures: takes a tissue sample (biopsy), removes a nasal polyp (polypectomy), or clears away infected or diseased tis...
- Typical setting: ENT doctor's office, hospital outpatient
- National avg charge (illustrative): $800–$3,500 (varies significantly by setting — office vs. surgery center vs. hospital, and by whether multiple sinus procedures are performed)
- Most-disputed reason: Being charged for 31237 in addition to more comprehensive sinus surgery codes (e.g., 31254, 31255, 31267) without documentation that the biopsy or debridement was performed at a separate, distinct anatomic site — this code is labeled 'separate procedure' and may be bundled into more extensive work.
What it means
What 31237 actually means
The surgeon inserts a thin camera into your nasal passages and sinuses and performs one of three procedures: takes a tissue sample (biopsy), removes a nasal polyp (polypectomy), or clears away infected or diseased tissue (debridement). This is a minor surgical procedure performed endoscopically, often in an office or outpatient setting.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Being charged for 31237 in addition to more comprehensive sinus surgery codes (e.g., 31254, 31255, 31267) without documentation that the biopsy or debridement was performed at a separate, distinct anatomic site — this code is labeled 'separate procedure' and may be bundled into more extensive work.
- Multiple sinus endoscopy codes billed on the same claim without a clear operative report identifying each distinct procedure at a distinct anatomic location.
- Facility fee plus physician fee both appearing as surgical charges rather than clearly separated — verify that the surgeon's fee and the surgery center or hospital facility fee are itemized separately on your bill.
If you see 31237 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 31237 often also see these adjacent codes on the same bill.
CPT
36415 — Routine venipuncture for collection of specimen
Verify the code matches the actual service and dose.
CPT
36416 — Collection of capillary blood specimen, finger, heel, or ear stick
Verify the code matches the actual service and dose.
CPT
38221 — Bone marrow biopsy, needle; first sampling
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 31237 on a bill.
31237 FAQ
Plain-English answers.
What does 31237 usually cost?
$800–$3,500 (varies significantly by setting — office vs. surgery center vs. hospital, and by whether multiple sinus procedures are performed). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 31237?
Being charged for 31237 in addition to more comprehensive sinus surgery codes (e.g., 31254, 31255, 31267) without documentation that the biopsy or debridement was performed at a separate, distinct anatomic site — this code is labeled 'separate procedure' and may be bundled into more extensive work.
What should I do if I see 31237 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 31237 before paying.
Don't pay 31237 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.