CPT 15731 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15731 |
National average reimbursement for CPT 15731 by major payers:
$1,278.43
$1,430.69
$1,460.99
$1,839.62
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 15731 | ||||||
United | 15731 | $3623.00 | 1285815522 - TLC ASC, LLC, KZMSS AGAIN, LLLP | 201952603 - (FL) TLC ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $2076.00 | 1508005976 - SOUTH SHORE SC, LLC | 341997077 - (NY) SOUTH SHORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1775.00 | 1790265999 - MUVE | 822351627 - (PA) MUVE | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $2781.00 | 1790066876 - CAROMONT HEALTH SERVICES, INC., CAROMONT ENDOSCOPY CENTER | 561455630 - (NC) CAROMONT HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $2050.00 | 1215675111 - GRANGER SURGERY CENTER LLC, NORTHERN INDIANA SURGERY CENTER LLC | 850956968 - (IN) GRANGER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $626.00 | 1649662206 - ADVANCED SURGERY CENTER OF ARIZONA, LLP, ADVANCED SURGERY CENTER OF ARIZONA | 471883984 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1300.00 | 1225510159 - SOUTHWEST SURGERY CENTER LLC | 825304896 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $2078.00 | 1679728901 - ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | 263777820 - (NJ) ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $3570.00 | 1851950281 - YUMA ADVANCED SURGICAL SUITES LLC | 833076801 - (AZ) YUMA ADVANCED SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $5651.00 | 1487136412 - ENDOSCOPY CENTER OF SOUTH SACRAMENTO, LLC, ENDOSCOPY CENTER OF SOUTH SACRAMENTO | 364904884 - (CA) ENDOSCOPY CENTER OF SOUTH SACRAMENTO LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $2860.00 | 1912090432 - MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE, LLC | 812557673 - (DC) MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE LLC | DC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $3623.00 | 1538461348 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. D/B/A THE OUTPATIENT CENT | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $5015.00 | 1427049352 - CENTER FOR AMBULATORY SURGERY, LLC, THE CENTER FOR AMBULATORY SURGERY | 223638149 - (NJ) THE CENTER FOR AMBULATORY SURGERY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $849.00 | 1366032617 - EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER, LLC | 843673604 - (MA) EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $4339.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 15731 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15731 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 15731 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 15574-CPT | High | Formation Of Direct Or Tubed Pedicle, With Or Without Transfer; Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands Or Feet |
| 15650-CPT | Moderate | Trans Intermediate Pedicle Flap Any Loca |
| 15730-CPT | High | Midface Flap (Ie Zygomaticofacial Flap) With Preservation Of Vascular Pedicle(S) (Reinstated Code) Old Desc: Preparation For Skin Graft; Eyelids Nose Ears Lips (Deleted 3/31/2003) |
| 15731-CPT | High | Foreheard Flap W/Preservation Of Vascular Pedicle |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15731. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15731 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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