CPT 31367 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 • GC - Service performed by resident under supervision • 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31367 |
National average reimbursement for CPT 31367 by major payers:
$2,682.15
$2,823.90
$3,013.70
$3,575.75
| 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 31367 | ||||||
United | 31367 | $515.00 | 1760849889 - SURGERY CENTER AT CORPORATE WAY LLC | 473812657 - (OH) SURGERY CENTER AT CORPORATE WAY LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $1064.00 | 1740260926 - STARK AMBULATORY SURGERY CENTER, LLC | 611448511 - (OH) STARK AMBULATORY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $300.00 | 1932207669 - EYE SURGICAL CENTER OF MISSISSIPPI | 200669972 - (MS) EYE SURGICAL CENTER OF MISSISSIPPI | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $498.00 | 1508839473 - NEWARK ENDOSCOPY ASC LLC, ENDOSCOPY CENTER OF DELAWARE | 621867825 - (DE) NEWARK ENDOSCOPY ASC LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $104.00 | 1760454557 - PHOENIX OPHTHALMOLOGY ASC LLC, ARIZONA OPHTHALMIC OUTPATIENT SURGERY | 621726788 - (AZ) PHOENIX OPHTHALMOLOGY ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $1100.00 | 1881850386 - THE CORVALLIS CLINIC PC | 931221257 - (OR) THE CORVALLIS CLINIC, P.C. | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $7400.00 | 1306163431 - ROC SURGERY LLC, RILEY OUTPATIENT SURGERY CENTER | 271497960 - (IN) ROC SURGERY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $834.00 | 1568840528 - ALPHARETTA SURGERY CENTER LLC | 208459286 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $618.00 | 1740787068 - CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION), CLEVELAND CLINIC FLORIDA CORAL SPRINGS ASC | 650003177 - CLEVELAND CLINIC FLORIDA A NONPROFIT CORPORATION | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $451.00 | 1285065490 - MASON ESC, LLC, MASON EYE SURGERY CENTER | 462015301 - (NY) MASON ESC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $434.00 | 1114929957 - OPHTHALMIC OUTPATIENT SURGERY CENTER PARTNERS, LLC, OUTPATIENT SURGERY CENTER FOR SIGHT | 721405960 - (LA) OPHTHALMIC OUTPATIENT SURGERY CENTER PARTNERS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $2040.00 | 1225531544 - ANNE ARUNDEL-SCA SURGICENTER, LLC | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $620.00 | 1588181275 - CHASE GARDENS SURGERY CENTER LLC | 822393658 - (OR) CHASE GARDENS SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $644.00 | 1780618801 - PINEY ORCHARD SURGERY CENTER, LLC. | 521938770 - (MD) PINEY ORCHARD SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31367 | $350.00 | 1720270879 - AKSTEIN EYE CENTER, ASC, AKSTEIN EYE CENTER, ASC | 581597344 - (GA) AKSTEIN EYE CENTER PC | GA | 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 31367 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31367 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 31367 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 |
|---|---|---|
| 31254-CPT | Moderate | Nasal/Sinus Endoscopy Surgical With Ethmoidectomy; Partial (Anterior) (Desc Revised 1/1/2018) |
| 31257-CPT | Moderate | Nasal/Sinus Endoscopy, Surgical With Ethmoidectomy; Total (Anterior And Posterior), Including Sphenoidotomy |
| 31300-CPT | High | Laryngtomy W Excision Lesion |
| 31367-CPT | High | Laryngect Subtot Supraglot Wo Neck |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31367. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31367 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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