Cost analysis for CPT 31231 — Diagnostic exam of nasal passages using an endoscope
Average Medicare Payment
$129.93
2023 data
Total Payments (2023)
$89.7M
Services (2023)
668.6K
Price Change (2014–2023)
-13.1%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $149.47 | $76.8M | 490.3K | — |
| 2015 | $150.12 | $80.1M | 507.8K | +0.4% |
| 2016 | $147.97 | $84.1M | 539.8K | -1.4% |
| 2017 | $144.26 | $85.7M | 564.6K | -2.5% |
| 2018 | $145.55 | $92.0M | 600.7K | +0.9% |
| 2019 | $140.97 | $93.8M | 634.4K | -3.1% |
| 2020 | $135.59 | $64.6M | 455.2K | -3.8% |
| 2021 | $141.75 | $80.4M | 544.9K | +4.5% |
| 2022 | $132.84 | $83.4M | 603.9K | -6.3% |
| 2023 | $129.93 | $89.7M | 668.6K | -2.2% |
The most expensive state pays 3.8x more than the cheapest for this procedure. DC averages $170.50 vs VT at $45.15.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| DC | $170.50 | $396.1K | 2.3K | 18 |
| NY | $167.15 | $15.7M | 93.8K | 516 |
| NJ | $162.25 | $5.9M | 36.2K | 230 |
| MD | $154.80 | $2.6M | 17.1K | 128 |
| CT | $153.78 | $1.2M | 7.6K | 84 |
| HI | $146.33 | $333.5K | 2.3K | 16 |
| RI | $142.65 | $120.5K | 845 | 11 |
| AK | $141.75 | $52.7K | 372 | 9 |
| FL | $139.92 | $12.8M | 91.5K | 523 |
| PR | $138.59 | $145.7K | 1.1K | 21 |
| CO | $136.52 | $1.2M | 8.6K | 123 |
| WY | $136.31 | $73.1K | 536 | 12 |
| TX | $135.43 | $4.6M | 33.9K | 448 |
| MA | $134.46 | $3.0M | 22.1K | 191 |
| AZ | $134.35 | $2.0M | 14.8K | 122 |
| IL | $133.61 | $3.0M | 22.6K | 241 |
| ME | $132.69 | $155.6K | 1.2K | 16 |
| VA | $132.29 | $1.7M | 12.5K | 170 |
| WA | $132.06 | $979.6K | 7.4K | 126 |
| MN | $131.78 | $586.5K | 4.5K | 94 |
| PA | $131.25 | $4.8M | 36.3K | 317 |
| DE | $131.01 | $404.8K | 3.1K | 21 |
| GA | $129.45 | $2.1M | 16.5K | 229 |
| IN | $128.45 | $902.0K | 7.0K | 97 |
| MO | $127.99 | $685.3K | 5.4K | 98 |
| NV | $127.81 | $337.7K | 2.6K | 24 |
| KY | $127.57 | $707.8K | 5.5K | 76 |
| OK | $126.56 | $451.1K | 3.6K | 57 |
| KS | $124.71 | $675.3K | 5.4K | 64 |
| SC | $124.21 | $1.7M | 13.7K | 138 |
| MT | $123.26 | $224.3K | 1.8K | 26 |
| NC | $123.06 | $1.7M | 13.6K | 201 |
| AR | $122.34 | $238.7K | 2.0K | 33 |
| OR | $122.08 | $534.8K | 4.4K | 73 |
| LA | $121.03 | $671.9K | 5.6K | 89 |
| SD | $120.06 | $121.4K | 1.0K | 22 |
| MI | $119.55 | $920.9K | 7.7K | 160 |
| TN | $117.81 | $954.9K | 8.1K | 122 |
| MS | $116.15 | $363.5K | 3.1K | 43 |
| ID | $114.05 | $153.3K | 1.3K | 27 |
| AL | $113.72 | $684.0K | 6.0K | 82 |
| NE | $109.17 | $405.9K | 3.7K | 56 |
| WV | $108.30 | $124.0K | 1.1K | 28 |
| UT | $107.29 | $215.4K | 2.0K | 42 |
| IA | $107.05 | $489.7K | 4.6K | 73 |
| OH | $105.02 | $1.2M | 11.2K | 182 |
| CA | $104.91 | $10.8M | 103.4K | 539 |
| WI | $100.74 | $405.4K | 4.0K | 103 |
| NM | $97.62 | $157.5K | 1.6K | 34 |
| NH | $87.71 | $104.1K | 1.2K | 28 |
| ND | $60.83 | $27.0K | 444 | 13 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Harvey Paley | Otolaryngology | CA | $1.1M | 36.4K | $29.62 |
| Robert Miller | Otolaryngology | FL | $338.2K | 2.5K | $136.37 |
| Bernard Durante | Otolaryngology | MA | $304.3K | 2.0K | $153.47 |
| Michael Kim | Otolaryngology | CA | $293.1K | 1.7K | $176.87 |
| Anit Patel | Otolaryngology | MA | $279.1K | 1.8K | $154.22 |
| Todd Parnes | Otolaryngology | FL | $272.1K | 1.8K | $151.85 |
| Daniel Branovan | Otolaryngology | NY | $270.8K | 1.6K | $170.62 |
| Winston Vaughan | Otolaryngology | CA | $257.1K | 1.4K | $179.07 |
| Khrosrow Makki | Otolaryngology | DC | $244.3K | 1.4K | $174.78 |
| Matthew Nagorsky | Otolaryngology | PA | $236.6K | 1.5K | $159.03 |
| Kenneth Scioscia | Otolaryngology | NY | $226.9K | 1.3K | $169.62 |
| Thomas Magardino | Otolaryngology | FL | $225.6K | 1.5K | $150.03 |
| Boris Bentsianov | Otolaryngology | NY | $209.3K | 1.1K | $182.00 |
| Navin Mehta | Otolaryngology | NY | $203.1K | 1.2K | $175.38 |
| Michael Bibliowicz | Otolaryngology | FL | $189.5K | 1.5K | $128.85 |
| Robert Nunez | Otolaryngology | FL | $185.3K | 1.2K | $152.01 |
| Christopher Walz | Otolaryngology | CA | $182.6K | 1.2K | $156.90 |
| George Domb | Otolaryngology | CA | $172.4K | 1.1K | $152.88 |
| Dan Moskowitz | Otolaryngology | NY | $168.9K | 964 | $175.23 |
| Milo Bastianelli | Otolaryngology | FL | $168.9K | 1.1K | $151.73 |
The data suggests significant pricing inconsistencies for CPT 31231. With a 3.8x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
While costs have decreased 13.1% since 2014, the wide state-by-state variation suggests the pricing formula may not adequately account for regional differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.