CPT 31293 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 • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31293 |
National average reimbursement for CPT 31293 by major payers:
$1,462.22
$1,429.39
$1,502.52
$1,788.42
| 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 31293 | ||||||
United | 31293 | $1243.00 | 1861550246 - BOYNTON BEACH ASC, LLC | 260084502 - (FL) BOYNTON BEACH ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $3976.00 | 1104082692 - OLD TESSON SURGERY CENTER, L.P., OLD TESSON SURGERY CENTER | 262876334 - (MO) OLD TESSON SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $2000.00 | 1962953018 - THE SURGERY CENTER AT TGH BRANDON HEALTHPLEX LLC | 611795393 - (FL) THE SURGERY CENTER AT TGH BRANDON HEALTHPLEX LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $950.00 | 1487014361 - GRIFFIN CENTER FOR PAIN AND SPINE | 473061907 - (GA) GRIFFIN CENTER FOR PAIN AND SPINE | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $1180.00 | 1235163171 - SEVEN SPRINGS SURGERY CENTER INC | 593044807 - (FL) SEVEN SPRINGS SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $1211.00 | 1295002806 - HERITAGE ONE DAY SURGERY LLC | 453788494 - (NY) HERITAGE ONE DAY SURGERY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $3500.00 | 1992992994 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $1156.00 | 1609399963 - INTERVENTIONAL SURGERY INSTITUTE OF WHITE HALL LLC | 814296629 - (AR) INTERVENTIONAL SURGERY INSTITUTE OF WHITE HALL LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $1964.00 | 1699246181 - DEERBROOK ASC LLC | 823478937 - (TX) DEERBROOK ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $1190.00 | 1235105248 - GURLEY SURGERY CENTER, THE GYN CENTER | 621159796 - (TN) GURLEY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $2847.00 | 1609871847 - THE SURGERY CENTER, LLC | 582520623 - (GA) THE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $1525.00 | 1689624793 - SURGERY CENTER OF SOUTHWEST FLORIDA INC | 843798404 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $1200.00 | 1821010638 - CATARACT AND LASER CENTER LLC | 522066053 - (DE) CATARACT AND LASER CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $7323.00 | 1285912600 - THE EMORY CLINIC INC, THE EMORY CLINIC LAGRANGE SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31293 | $2280.00 | 1326045014 - GROVE PLACE SURGERY CENTER ,LLC | 10619096 - (FL) GROVE PLACE SURGERY CENTER, LLC | FL | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 31293 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31293 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 31293 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 |
|---|---|---|
| 31290-CPT | High | Endoscopy, Surg, W Repair Of Cerebrospinal Fluid Lead; Ethmoid Region |
| 31291-CPT | High | Endoscopy, Surg, W Repair Of Cerebrospinal Fluid Leak; Sphenoid Region |
| 31292-CPT | High | Nasal/Sinus Endoscopy Surgical With Orbital Decompression; Medial Or Inferior Wall (Desc Rvsd 1/1/20) |
| 31293-CPT | High | Nasal/Sinus Endoscopy Surgical With Orbital Decompression; Medial And Inferior Wall (Desc Rvsd 1/1/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31293. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31293 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 31293) and we'll show you how you compare in 15 minutes or less.