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 |
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 | $2078.00 | 1679728901 - ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | 263777820 - (NJ) ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | NJ | 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 | $1280.00 | 1649511577 - THE SURGERY CENTER AT ORTHOPEDIC ASSOCIATES, LLC | 461267019 - (NY) THE SURGERY CENTER AT ORTHOPEDIC ASSOCIATES LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1200.00 | 1679521389 - WESLEY & KLIPPENSTEIN, PC, WESLEY OPHTHALMIC PLASTIC SURGERY CENTER | 621799761 - (TN) WESLEY & KLIPPENSTEIN, P.C. | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1964.00 | 1376852855 - PAIN MANAGEMENT PROFESSIONALS OF BAYTOWN PLLC, ADVANCED PAIN MANAGEMENT SPECIALISTS OF BAYTOWN | 263216787 - PAIN MANAGEMENT PROFESSIONALS OF BAYTOWN PLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $8266.00 | 1225091721 - EL PASO SURGERY CENTERS LP | 621846494 - (TX) EL PASO SURGERY CENTERS LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1278.00 | 1477516532 - SPECIALTY SURGICARE OF LAS VEGAS, LP | 260116160 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $3500.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1520.00 | 1023169380 - JCMG SURGERY CENTER, INC. | 431809950 - (MO) JCMG SURGERY CENTER INC | MO | 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 | $3500.00 | 1194724690 - ENDOSCOPY CENTER OF DAYTON NORTH LLC | 311703317 - (OH) ENDOSCOPY CENTER OF DAYTON NORTH LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1142.00 | 1568448660 - PROGRESSIVE SURGICAL INSTITUTE INC. | 232973820 - (PA) PROGRESSIVE SURGICAL INSTITUTE INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15731 | $1961.23 | 1063613727 - MICHAEL DYMOND | 350593390 - DEACONESS HOSPITAL INC | CA | Anesthesiology Physician (207L00000X) |
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 | $9270.00 | 1346235058 - EAST MEQUON SURGERY CENTER LLC | 861075286 - (WI) EAST MEQUON SURGERY CENTER LLC | WI | 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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