Removal of nasal sinus tissue using an endoscope
Medicare pricing data for 5,194 providers across 51 states
This procedure has a 5.8x markup — hospitals charge $3,953 but Medicare allows only $684.90. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. Prices vary significantly by location — from $247 in Vermont to $1,192 in Alaska. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Removal of nasal sinus tissue using an endoscope (HCPCS code 31267) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $684.90, but hospitals typically charge $3,953 — a 5.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $684.90, your out-of-pocket cost would be approximately $136.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $545.26 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $1,192 | $9,928 | 16 | 60 | +74.1% |
| Wyoming | $915 | $4,017 | 14 | 73 | +33.6% |
| New Jersey | $913 | $5,230 | 128 | 596 | +33.2% |
| Maryland | $896 | $4,647 | 90 | 497 | +30.8% |
| Arizona | $852 | $4,864 | 96 | 792 | +24.3% |
| Nevada | $836 | $3,466 | 27 | 148 | +22.1% |
| California | $830 | $4,748 | 461 | 2,254 | +21.2% |
| Oregon | $795 | $3,572 | 91 | 346 | +16.0% |
| Indiana | $782 | $5,268 | 131 | 641 | +14.2% |
| Colorado | $778 | $5,702 | 113 | 491 | +13.6% |
| Kansas | $752 | $5,246 | 62 | 977 | +9.8% |
| Iowa | $735 | $3,604 | 58 | 290 | +7.3% |
| Utah | $733 | $3,039 | 65 | 222 | +7.0% |
| Idaho | $716 | $2,302 | 38 | 152 | +4.5% |
| Alabama | $715 | $3,206 | 103 | 606 | +4.3% |
| Florida | $714 | $4,278 | 359 | 1,938 | +4.3% |
| North Carolina | $712 | $3,629 | 181 | 884 | +3.9% |
| Texas | $710 | $4,782 | 452 | 2,236 | +3.6% |
| South Carolina | $708 | $2,919 | 103 | 688 | +3.4% |
| Washington | $696 | $2,536 | 120 | 634 | +1.5% |
| Virginia | $691 | $3,868 | 117 | 420 | +0.9% |
| Rhode Island | $691 | $3,133 | 11 | 24 | +0.8% |
| Montana | $676 | $2,483 | 29 | 142 | -1.4% |
| Delaware | $669 | $2,021 | 13 | 157 | -2.3% |
| Connecticut | $668 | $4,608 | 47 | 130 | -2.5% |
| Hawaii | $663 | $3,164 | 14 | 91 | -3.2% |
| Kentucky | $651 | $3,015 | 63 | 238 | -5.0% |
| Mississippi | $643 | $3,309 | 57 | 386 | -6.1% |
| Tennessee | $629 | $3,881 | 130 | 778 | -8.2% |
| Nebraska | $621 | $2,460 | 46 | 181 | -9.3% |
| Wisconsin | $612 | $4,957 | 94 | 342 | -10.7% |
| Georgia | $611 | $2,964 | 179 | 729 | -10.8% |
| New Hampshire | $606 | $4,573 | 30 | 96 | -11.5% |
| Arkansas | $599 | $1,530 | 36 | 118 | -12.5% |
| Minnesota | $593 | $3,862 | 74 | 265 | -13.4% |
| Pennsylvania | $566 | $2,863 | 228 | 999 | -17.4% |
| Illinois | $559 | $4,347 | 181 | 672 | -18.4% |
| Michigan | $554 | $3,082 | 159 | 557 | -19.2% |
| Missouri | $550 | $3,662 | 105 | 469 | -19.7% |
| North Dakota | $549 | $2,377 | 17 | 48 | -19.8% |
| New York | $541 | $4,619 | 224 | 688 | -21.1% |
| New Mexico | $512 | $5,762 | 18 | 57 | -25.3% |
| Louisiana | $502 | $3,175 | 110 | 441 | -26.7% |
| Ohio | $475 | $2,050 | 176 | 664 | -30.6% |
| Massachusetts | $384 | $2,219 | 94 | 284 | -43.9% |
| Oklahoma | $376 | $2,046 | 60 | 234 | -45.1% |
| District of Columbia | $272 | $1,428 | 8 | 22 | -60.4% |
| South Dakota | $264 | $1,900 | 24 | 85 | -61.5% |
| Maine | $262 | $1,134 | 17 | 42 | -61.8% |
| West Virginia | $252 | $1,191 | 20 | 47 | -63.2% |
| Vermont | $247 | $1,421 | 5 | 14 | -63.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber