CPT 31084 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 Respiratory System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31084 |
National average reimbursement for CPT 31084 by major payers:
$1,624.40
$1,521.30
$1,633.08
$1,974.28
| 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 31084 | ||||||
United | 31084 | $16257.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $1700.00 | 1407227358 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT NORTHPOINT | 650592518 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $800.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $5745.00 | 1184195877 - ALPINE SURGICENTER, LLC | 204038061 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $7225.00 | 1205892197 - ALASKA SURGERY CENTER, LIMITED PARTNERSHIP | 930982396 - (AK) ALASKA SURGERY CENTER LIMITED PARTNERSHIP | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $1919.00 | 1285678979 - BAY SURGERY CENTERS LLC, CLEARWAY SURGERY CENTER OF ANNAPOLIS | 204934078 - (MD) BAY SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $6506.00 | 1467999813 - WEBSTER OUTPATIENT SURGERY CENTER, LLC, WEBSTER OUTPATIENT SURGERY CENTER | 845046625 - (CA) WEBSTER OUTPATIENT SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $6506.00 | 1215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $1919.00 | 1649735861 - KURESMART PAIN MANAGEMENT SURGERY CENTER-CATONSVILLE LLC, CLEARWAY SURGERY CENTER OF CATONSVILLE | 832414671 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCATONSVILLE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $7718.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $5354.00 | 1427003052 - EYE SURGERY CENTER OF NASHVILLE LLC | 621872622 - (TN) EYE SURGERY CENTER OF NASHVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $3558.00 | 1922438472 - PARK AMBULATORY SURGERY CENTER, LLC | 463665760 - (TX) PARK AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $2050.00 | 1700974995 - THE NEW JERSEY CENTER FOR EAR, NOSE AND THROAT DISORDERS, P.C. | 202822342 - (NJ) THE NEW JERSEY CENTER FOR EAR NOSE AND THROAT DISORDERS PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $3065.00 | 1811926728 - FOOTHILL SURGERY CENTER, LLC, FOOTHILL SURGERY CENTER | 510453471 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31084 | $1983.00 | 1447254172 - SURGICENTER OF BALTIMORE LLC, SURGICENTER OF BALTIMORE | 521658841 - (MD) SURGICENTER OF BALTIMORE LLC | MD | 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 31084 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31084 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 31084 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 |
|---|---|---|
| 31080-CPT | High | Sinusotomy Front Oblit Wo Flap Brow |
| 31081-CPT | High | Sinusotomy Front;Obliterative W/O Flap,C |
| 31084-CPT | High | Sinusotomy Front Oblit W 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 31084. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31084 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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