CPT 31297: Endoscopic Transnasal Sphenoid Sinus Ostium Dilation

Medicare pays $1637 on average nationally for this procedure.

CPT code 31297 describes endoscopic transnasal dilation of the sphenoid sinus ostium, a minimally invasive nasal endoscopy procedure performed to enlarge the sphenoid sinus opening; service type: diagnostic/therapeutic nasal endoscopy with dilation, typical site of service: ambulatory surgical center or hospital outpatient department. Data not available in the input.

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CPT 31297: Endoscopic Transnasal Sphenoid Sinus Ostium Dilation

Medicare pays $1637 on average nationally for this procedure.

Customize your policy alerts

Sign up for cpt 31297 policy alerts

Get alerted when payer policies referencing 31297 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A 48-year-old patient presents to an otolaryngology clinic with persistent postnasal drainage, facial pressure localized to the sphenoid region, and recurrent headaches despite medical therapy including intranasal corticosteroids and antibiotics. Nasal endoscopy and CT sinus imaging demonstrate sphenoid ostial narrowing with mucosal thickening and retention consistent with chronic sphenoid sinusitis and ostial stenosis. The patient is scheduled for an in-office or operating room endoscopic procedure under monitored anesthesia care or general anesthesia.

The procedure involves passage of a nasal endoscope through the nasal cavity to visualize the sphenoethmoidal recess and identify the sphenoid ostium. Under direct visualization, the provider dilates the sphenoid ostium (balloon or mechanical dilation) to re-establish drainage and ventilation of the sphenoid sinus. Intraoperative steps include topical decongestion, endoscopic inspection, ostial localization, controlled dilation of the ostium, hemostasis, and postoperative nasal packing or splinting if indicated. Typical perioperative documentation includes indication, informed consent, preoperative imaging findings, anesthesia type, procedural technique (instrumentation and dilation method), ostium size pre- and post-dilation, estimated blood loss, complications, and postoperative instructions for saline irrigations and follow-up endoscopy.

Typical site of service: ambulatory surgical center or hospital outpatient/operating room; selected cases may be performed in a procedure room under local anesthesia.

Typical patient scenario modifiers: patients may have prior sinus surgery, bilateral disease, or require concurrent procedures such as septoplasty or ethmoidectomy; documentation should support any modifier applied (e.g., laterality, increased procedural services, or unrelated concurrent procedures).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31276`	Nasal/sinus endoscopy, surgical, with dilation (balloon) of frontal and/or maxillary and/or sphenoid sinus ostium(s) when performed	May be used alternatively or in conjunction when balloon dilation addresses multiple sinuses including the sphenoid during the same session.
`31267`	Nasal/sinus endoscopy, surgical, with maxillary antrostomy	Common concurrent procedure when maxillary disease coexists and requires widening of the maxillary ostium.
`31254`	Nasal/sinus endoscopy, diagnostic, with biopsy, polypectomy or debridement	Performed before or after dilation for tissue sampling or removal of obstructing polyps or debris.
`30520`	Repair, nasal septum, submucous, with partial turbinectomy when performed	Frequently performed concurrently to improve access and visualization if septal deviation limits endoscopic reach.
`31575`	Laryngoscopy, flexible; diagnostic	Performed in preoperative airway evaluation or when concomitant laryngeal symptoms require assessment.

Related Modifiers

9 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
305R00000X	Preferred Provider Organization	A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the phys…
183700000X	Pharmacy Technician	A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professi…
207P00000X	Emergency Medicine Physician	An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
2083C0008X	Clinical Informatics Physician	Physicians who practice Clinical Informatics collaborate with other health care and information technology professionals to analyze, design, implement…
364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

Related Payer Policy Updates

Specialty: Anesthesiology1 / 3

10 rows

Policy	Payer	Effective Date
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Elective Inpatient Services (for Idaho Only)	UnitedHealthcare	2026-06-01
Sites of Service	priority health	2026-06-01
Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Services	univerahealthcare	2026-05-21
Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_Blocks	Cigna	2026-05-15
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01

CPT 31231: Nasal Endoscopy, Diagnostic

CPT-31233-MAXILLARY-SINUS-DIAGNOSTIC-ENDOSCOPY-THROUGH-CANINE-FOSSA-OR-INFERIOR-MEATUS

CPT 31233: Diagnostic Endoscopy of Maxillary Sinus via Canine Fossa

CPT-31235-SPHENOID-SINUS-DIAGNOSTIC-ENDOSCOPY

CPT 31235: Diagnostic Endoscopy of Sphenoid Sinus

CPT-31237-NASAL-ENDOSCOPY-BIOPSY-POLYPECTOMY-DEBRIDEMENT

CPT 31237: Nasal/Sinus Endoscopy with Biopsy or Polypectomy

CPT-31238-ENDOSCOPIC-NASAL-HEMOSTASIS

CPT 31238: Endoscopic Nasal Cautery for Control of Bleeding

CPT-31239-DACRYOCYSTORHINOSTOMY-EXTERNAL-DCR

CPT 31239: Dacryocystorhinostomy (External DCR)

CPT-31240-ENDOSCOPIC-CONCHA-BULLOSA-REMOVAL

CPT 31240: Endoscopic-Assisted Concha Bullosa Removal

CPT-31241-ENDOSCOPIC-SPHENOPALATINE-ARTERY-LIGATION-NASAL

CPT 31241: Endoscopic Ligation of Sphenopalatine Artery

CPT-31242-POSTERIOR-NASAL-NERVE-RADIOFREQUENCY-ABLATION-ENDOSCOPIC

CPT 31242: Endoscopic Posterior Nasal Nerve Radiofrequency Ablation

CPT-31243-POSTERIOR-NASAL-NERVE-CRYOABLATION-ENDOSCOPIC

CPT 31243: Endoscopic Posterior Nasal Nerve Cryoablation

Showing 1–10 of 28

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Typical site of service: ambulatory surgical center or hospital outpatient/operating room; selected cases may be performed in a procedure room under local anesthesia.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31276`	Nasal/sinus endoscopy, surgical, with dilation (balloon) of frontal and/or maxillary and/or sphenoid sinus ostium(s) when performed	May be used alternatively or in conjunction when balloon dilation addresses multiple sinuses including the sphenoid during the same session.
`31267`	Nasal/sinus endoscopy, surgical, with maxillary antrostomy	Common concurrent procedure when maxillary disease coexists and requires widening of the maxillary ostium.
`31254`	Nasal/sinus endoscopy, diagnostic, with biopsy, polypectomy or debridement	Performed before or after dilation for tissue sampling or removal of obstructing polyps or debris.
`30520`	Repair, nasal septum, submucous, with partial turbinectomy when performed	Frequently performed concurrently to improve access and visualization if septal deviation limits endoscopic reach.
`31575`	Laryngoscopy, flexible; diagnostic	Performed in preoperative airway evaluation or when concomitant laryngeal symptoms require assessment.

Related Modifiers

9 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
305R00000X	Preferred Provider Organization	A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the phys…
183700000X	Pharmacy Technician	A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professi…
207P00000X	Emergency Medicine Physician	An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
2083C0008X	Clinical Informatics Physician	Physicians who practice Clinical Informatics collaborate with other health care and information technology professionals to analyze, design, implement…
364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

Related Payer Policy Updates

Specialty: Anesthesiology1 / 3

10 rows

Policy	Payer	Effective Date
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Elective Inpatient Services (for Idaho Only)	UnitedHealthcare	2026-06-01
Sites of Service	priority health	2026-06-01
Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Services	univerahealthcare	2026-05-21
Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_Blocks	Cigna	2026-05-15
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01

CPT 31231: Nasal Endoscopy, Diagnostic

CPT-31233-MAXILLARY-SINUS-DIAGNOSTIC-ENDOSCOPY-THROUGH-CANINE-FOSSA-OR-INFERIOR-MEATUS

CPT 31233: Diagnostic Endoscopy of Maxillary Sinus via Canine Fossa

CPT-31235-SPHENOID-SINUS-DIAGNOSTIC-ENDOSCOPY

CPT 31235: Diagnostic Endoscopy of Sphenoid Sinus

CPT-31237-NASAL-ENDOSCOPY-BIOPSY-POLYPECTOMY-DEBRIDEMENT

CPT 31237: Nasal/Sinus Endoscopy with Biopsy or Polypectomy

CPT-31238-ENDOSCOPIC-NASAL-HEMOSTASIS

CPT 31238: Endoscopic Nasal Cautery for Control of Bleeding

CPT-31239-DACRYOCYSTORHINOSTOMY-EXTERNAL-DCR

CPT 31239: Dacryocystorhinostomy (External DCR)

CPT-31240-ENDOSCOPIC-CONCHA-BULLOSA-REMOVAL

CPT 31240: Endoscopic-Assisted Concha Bullosa Removal

CPT-31241-ENDOSCOPIC-SPHENOPALATINE-ARTERY-LIGATION-NASAL

CPT 31241: Endoscopic Ligation of Sphenopalatine Artery

CPT-31242-POSTERIOR-NASAL-NERVE-RADIOFREQUENCY-ABLATION-ENDOSCOPIC

CPT 31242: Endoscopic Posterior Nasal Nerve Radiofrequency Ablation

CPT-31243-POSTERIOR-NASAL-NERVE-CRYOABLATION-ENDOSCOPIC

CPT 31243: Endoscopic Posterior Nasal Nerve Cryoablation

Showing 1–10 of 28

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 31297: Endoscopic Transnasal Sphenoid Sinus Ostium Dilation

Sign up for cpt 31297 policy alerts

OpenPayer

CPT 31297: Endoscopic Transnasal Sphenoid Sinus Ostium Dilation

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

CPT 31297: Endoscopic Transnasal Sphenoid Sinus Ostium Dilation

Sign up for cpt 31297 policy alerts

CPT 31297: Endoscopic Transnasal Sphenoid Sinus Ostium Dilation

Sign up for cpt 31297 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 31297 represent and where is this procedure usually performed?

What clinical and operative documentation elements are important when billing CPT 31297?

Which billing modifiers are associated with CPT 31297 and when are they used?

What related CPT codes might be billed alongside or instead of CPT 31297?

Which specialties perform CPT 31297 and which payers are commonly referenced for coverage and benchmarking?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 31297 represent and where is this procedure usually performed?

What clinical and operative documentation elements are important when billing CPT 31297?

Which billing modifiers are associated with CPT 31297 and when are they used?

What related CPT codes might be billed alongside or instead of CPT 31297?

Which specialties perform CPT 31297 and which payers are commonly referenced for coverage and benchmarking?

References