Summary & Overview
CPT 31267: Endoscopic Maxillary Antrostomy with Removal of Diseased Tissue
CPT code 31267 represents an endoscopic maxillary antrostomy with removal of diseased tissue via access through the uncinate process. This procedure is a common surgical intervention for chronic or recurrent maxillary sinus disease and is widely performed in ambulatory surgical centers and hospital outpatient departments. Nationally, accurate coding of CPT code 31267 matters for clinical documentation, quality measurement, and appropriate reimbursement for otolaryngology and rhinology services.
Key payers covered in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service, and the kinds of documentation elements that support use of this code. The publication also provides benchmarking perspectives and policy-relevant considerations for payers and providers, including where CPT code 31267 sits within endoscopic sinus surgery coding and common service-line implications.
This summary is intended to orient clinicians, billing professionals, and policy analysts to the clinical scope and administrative relevance of CPT code 31267 and the topics addressed in the full publication.
Billing Code Overview
CPT code 31267 describes an endoscopic surgical procedure in which an endoscope is inserted into the nasal cavity to gain access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus and removes diseased tissue.
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Service type: Endoscopic sinus surgery, maxillary antrostomy with debridement/removal of diseased tissue
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Typical site of service: Ambulatory surgical center or hospital outpatient department (endoscopic nasal/sinus surgery)
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to the otolaryngology clinic with a 6- to 12-week history of unilateral facial pressure, purulent nasal drainage, and diminished sense of smell despite prior outpatient medical therapy including oral antibiotics and topical nasal steroids. Nasal endoscopy demonstrates polypoid mucosa and purulent drainage from the middle meatus. Computed tomography of the sinuses shows opacification of the maxillary sinus with an obstructed ostiomeatal complex and an intact but medially displaced uncinate process. The patient is scheduled for endoscopic maxillary antrostomy and debridement under general anesthesia.
The clinical workflow: preoperative evaluation by the surgeon and anesthesia team, informed consent, intraoperative nasal endoscopy with insertion of a rigid endoscope into the nasal cavity, incision or removal of the uncinate process to gain access to the maxillary sinus, enlargement of the natural ostium (antrostomy), removal of diseased mucosa, polypoid tissue, and inspissated secretions, hemostasis and nasal packing as needed, postoperative recovery with discharge to home the same day or overnight observation for comorbidities, and standard follow-up visits for endoscopic debridement and wound care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting the surgeon's professional service separate from the facility or technical component (rare for operative CPTs billed by facility). |