CPT 31000 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Respiratory System |
| Common Place of Service | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 50 - Bilateral Procedure • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 31000 by major payers:

$226.44

$230.83

$246.04

$303.20
| 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 31000 | ||||||
United | 31000 | $128.00 | 1750362869 - EYE HEALTH EASTSIDE SURGERY CENTER | 680568557 - (OR) EYE HEALTH EASTSIDE SURGERY CENTER | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $244.00 | 1942335971 - PALOS SURGICENTER, LLC | 364404305 - (IL) PALOS SURGICENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $80.00 | 1124296173 - TREASURE COAST SURGICAL CENTER INC | 260770428 - (FL) TREASURE COAST SURGICAL CENTER, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $200.00 | 1568814010 - SURGERY CENTER OF CALIFORNIA -LLC | 812978830 - (CA) SURGERY CENTER OF CALIFORNIA LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $702.00 | 1659316917 - SUGAR LAND SURGERY CENTER LTD | 621742196 - (TX) SUGAR LAND SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $342.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $688.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $1029.00 | 1245768209 - TEXAS HEALTH SURGERY CENTER BEDFORD, LLC, TEXAS HEALTH SURGERY CENTER BEDFORD | 821307876 - (TX) TEXAS HEALTH SURGERY CENTER BEDFORD LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $643.00 | 1639850415 - MEDICAL CITY SURGERY CENTER OF ALLEN, LLC | 932106228 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $225.00 | 1154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE | 871712552 - (AZ) BSC 3 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $120.00 | 1053933952 - GASTROENTEROLOGY ASSOCIATES OF THE PIEDMONT, P.A., KERNERSVILLE ENDOSCOPY CENTER | 561251665 - (NC) GASTROENTEROLOGY ASSOCIATES OF THE PIEDMONT, PA | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $340.00 | 1275516718 - PREMIER SURGICAL CENTER, INC | 223717100 - PREMIER SURGICAL CENTER, LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $252.00 | 1891186987 - FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTER,LLC | 464426708 - (CO) FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTERLLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $129.00 | 1417362831 - J. GRAFF SURGERY CENTER INC, WILLOW BEND SURGERY CENTER OF PLANO | 463194833 - (TX) J GRAFF SURGERY CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31000 | $1708.00 | 1184752305 - SEASHORE SURGICAL INSTITUTE, LLC | 223660141 - (NJ) SEASHORE SURGICAL INSTITUTE | NJ | 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 31000 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31000 code is part of the Surgery services used for Surgical Procedures on the Respiratory 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 31000 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31000 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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