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See a sample rate comparisonCPT 31375 Fee Schedule
Last Verified: October 2026
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.
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| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 22 - Increased Procedural Services GC - Service performed by resident under supervision 52 - Reduced Services 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31375 |
| Medicaid Fee Schedule | View Medicaid rates for 31375 |
National average reimbursement for CPT 31375 by major payers:
$2,454.95
$2,521.18
$2,697.20
$3,131.26
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CPT 31375
5 of 25 sample ratesHigher to lower in this preview
Summit Surgical Center, LLC
$4,300.00Published rateNorth Haven Surgery Center LLC, North Haven Pain Medicine Center, LLC
North Haven Surgery Center LLC
$1,064.00Published rateCentral Coast Endoscopy Center Inc
$673.00Published rateUniversity Center For Ambulatory Surgery, LLC
University Center For Ambulatory Surgery LLC
$441.00Published rateMontgomery Eye Surgery Center LLC, Montgomery Eye Surgery Center
Montgomery Eye Surgery Center LLC
$150.00Published rate
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See a sample payer proposalCPT 31375 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31375 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 31375 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31375. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31375 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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