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 |
| Medicare Fee Schedule | View Medicare rates for 31087 |
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 | $2600.00 | 1629078043 - NOVAMED EYE SURGERY CENTER OF OVERLAND PARK, LLC, OVERLAND PARK SURGERY CENTER | 364130546 - (KS) NOVAMED EYE SURGERY CENTER OF OVERLAND PARK LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $2500.00 | 1164811923 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN AMBULATORY SURGERY CENTER-LEXINGTON | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $5433.00 | 1720325160 - SURGCENTER OF DEER VALLEY, LLC | 461512703 - (AZ) SURGCENTER OF DEER VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $584.00 | 1366651242 - MIAMI VALLEY AMBULATORY SURGERY CENTER LTD | 311559473 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $2243.00 | 1528369972 - INSIGHT GROUP, LLC | 261871061 - (LA) INSIGHT GROUP LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $5354.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $1050.00 | 1821471913 - ARIZONA SURGICAL SPECIALISTS CENTER, LLC, ARIZONA SURGICAL SPECIALSTS CENTER WEST PHOENIX | 760737449 - (AZ) ARIZONA SURGICAL SPECIALISTS CENTER LLC | AZ | 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 | $2300.00 | 1386999662 - PALOS HILLS SURGERY CENTER, LLC | 451617538 - (IL) PALOS HILLS SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $1907.00 | 1932390234 - RENO ORTHOPAEDIC SURGERY CENTER LLC | 208256389 - (NV) RENO ORTHOPAEDIC SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $3580.00 | 1912600826 - SURGICAL CENTER OF TVH | 882585662 - (ID) SURGICAL CENTER OF TVH | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $3465.00 | 1073149365 - MEDFORD SURGERY CENTER LLC | 384079196 - (MA) MEDFORD SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $2385.00 | 1932438553 - MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERY | 263528303 - (CT) MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERY | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $5433.00 | 1942715826 - SAFETY HARBOR ASC COMPANY LLC, SAFETY HARBOR SURGERY CENTER | 320547161 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31087 | $3973.00 | 1669895512 - AMBULATORY SURGICAL CENTER OF SOMERVILLE LLC, SOMERSET AMBULATORY SURGICAL CENTER | 371743209 | 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 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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