CPT 31070 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 31070 by major payers:
$612.46
$578.56
$637.35
$771.87
| 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 31070 | ||||||
United | 31070 | $2100.00 | 1225308257 - CROWN VALLEY OUTPATIENT SURGICAL CENTER LLC, MISSION ENDOSCOPY CENTER | 454125214 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $1660.00 | 1770019200 - GEORGIA CATARACT AND EYE SPECIALTY CENTER LLC, GEORGIA CATARACT AND EYE SPECIALTY CENTER | 461115901 - (GA) GEORGIA CATARACT AND EYE SPECIALTY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $1192.00 | 1750658092 - ADVANCED CENTER FOR SURGERY, LLC | 273049891 - (PA) ADVANCED CENTER FOR SURGERY, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $1245.00 | 1508210378 - APEX MEDICAL SURGERY CENTER, LLC | 471906463 - (GA) APEX MEDICAL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $15388.86 | 1538223714 - SAINT VINCENT HLTH CTR SPU | 250965547 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $2250.00 | 1952852345 - HUEBNER AMBULATORY SURGERY CENTER, LLC | 813360799 - (TX) HUEBNER AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $2611.00 | 1043283906 - NAUGATUCK VALLEY ENDOSCOPY CENTER, LLC, WATERBURY SURGERY CENTER | 260078381 - (CT) NAUGATUCK VALLEY ENDOSCOPY CENTE | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $731.00 | 1396897260 - LITTLE ROCK FERTILITY CENTER | 861078562 - (AR) LITTLE ROCK FERTILITY CENTER | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $814.00 | 1659526457 - NORWOOD ENDOSCOPY CENTER, LLC | 263691316 - (OH) NORWOOD ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $954.00 | 1508912262 - WAUKEGAN ILLINOIS HOSPITAL COMPANY LLC, VISTA SURGERY CENTER | 203978521 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $567.00 | 1821219718 - WASHINGTON SURGERY CENTER, LLC, WASHINGTON SURGERY CENTER, INC. | 412110716 - (MO) WASHINGTON SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $2206.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $2504.00 | 1710321328 - VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC | 800864336 - (CA) VALLEY PHYSICIANS SURGERY CENTER OF NORTHRIDGE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $3500.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31070 | $1582.00 | 1336254770 - EYE SURGERY CENTER OF THE DESERT | 330708059 - (CA) EYE SURGERY CENTER OF THE DESERT | CA | 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 31070 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31070 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 31070 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 |
|---|---|---|
| 31070-CPT | Moderate | Sinusotomy Frontal External Simple Treph |
| 31075-CPT | High | Sinusotomy Frontal; Transorbital Unilate |
| 31080-CPT | High | Sinusotomy Front Oblit Wo Flap Brow |
| 31276-CPT | Moderate | Nasal/Sinus Endoscopy Surgical With Frontal Sinusexploration Including Removal Of Tissue From Frontal Sinus When Performed (Desc Revised 1/1/2018) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31070. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31070 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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