CPT 31087 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 50 - Bilateral Procedure • LT - Left side of body • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 31087 by major payers:
$1,488.19
$1,424.31
$1,538.06
$1,836.52
| 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 31087 | ||||||
United | 31087 | $2250.00 | 1154554160 - CABRILLO SURGERY CENTER | 270666008 - (CA) CABRILLO SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $17751.47 | 1649392242 - ST. CLAIR MEMORIAL HOSPITAL | 251010303 - (PA) ST CLAIR HEALTH CORPORATION | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $2118.00 | 1568083103 - COLUMBIA PARKWAY SURGERY CENTER LLC | 850692755 - (MD) COLUMBIA PARKWAY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $890.00 | 1821106923 - ENDOSCOPY CENTER OF COASTAL GEORGIA, LLC | 582628189 - (GA) ENDOSCOPY CENTER OF COASTAL GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $3438.00 | 1558526293 - ENDOSCOPY CENTER OF THE ROCKIES LLC, ENDOSCOPY CENTER OF THE ROCKIES BOULDER | 841562782 - (CO) ENDOSCOPY CENTER OF THE ROCKIES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $2813.00 | 1144406927 - SAN ANTONIO TX ENDOSCOPY ASC LP, SAN ANTONIO GASTROENTEROLOGY ENDOSCOPY CENTER NORTH | 200075829 - (TX) SAN ANTONIO TX ENDOSCOPY ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $2814.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $1122.00 | 1720081870 - ORTHOPAEDIC AMBULATORY SURGICAL INTERVENTION SERVICES, LLC, OASIS | 582398485 - (OH) ORTHOPAEDIC AMBULATORY SURGICAL INTERVENTION SERVICES, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $1273.00 | 1114177417 - NISENFELD & CHILTON, MD PA, ORTHOPAEDIC ASSOCIATES OF FREDERICK, ASC | 521135399 - (MD) NISENFELD & CHILTON, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $5249.00 | 1588610190 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $6506.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $5249.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $5779.00 | 1235797630 - AUSTIN GI SURGICENTER, LLC, AUSTIN ENDOSCOPY CENTER | 301073754 - (TX) AUSTIN GI SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $11291.00 | 1689053050 - BELTWAY SURGERY CENTERS, LLC, MULTISPECIALTY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $5201.00 | 1861041139 - KADLEC REGIONAL MEDICAL CENTER, KADLEC AMBULATORY ENDOSCOPY CENTER, LEE CAMPUS | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | 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 31087 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31087 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 31087 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 |
|---|---|---|
| 31085-CPT | High | Sinusotomy Front; Obliter W Flap, Corona |
| 31086-CPT | High | Sinusotomy Frontal W Flap Brow |
| 31087-CPT | High | Sinusotomy Front;Nonobliter W Flap,Coron |
| 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 31087. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31087 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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