CPT 31380 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 |
| Common Modifiers | • None • AG - Primary physician • GC - Service performed by resident under supervision • LT - Left side of body • 51 - Multiple procedures • 82 - Assistant surgeon - no qualified resident • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31380 |
National average reimbursement for CPT 31380 by major payers:

$2,304.71

$2,490.57

$2,660.30

$3,157.53
| 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 31380 | ||||||
United | 31380 | $750.00 | 1467499293 - ST CLOUD MN OPHTHALMOLOGY ASC LLC, ST. CLOUD CENTER FOR OPHTHALMIC SURGERY | 203853072 - (MN) ST CLOUD MN OPHTHALMOLOGY ASC LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $491.00 | 1083638647 - WEST DES MOINES AMBULATORY SURGICAL CENTER LLC, WESTOWN AMBULATORY CENTER | 421469883 - (IA) WEST DES MOINES AMBULATORY SURGICAL CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $3931.00 | 1417922915 - FRANCONIA-SPRINGFIELD SURGERY CENTER, LLC, INOVA SURGERY CENTER @ FRANCONIA-SPRINGFIELD | 542018390 - (VA) INOVA AMBULATORY SURGICAL CENTERS | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $470.00 | 1265519821 - SEVEN HILLS SURGERY CENTER LLC | 203044042 - SEVEN HILLS SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $711.00 | 1053508077 - JOURNEY LITE OF CINCINNATI, LLC | 208861350 - (OH) JOURNEYLITE OF CINCINNATI, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $930.00 | 1689852618 - MILLARD FILLMORE SURGERY CENTER, LLC | 261582864 - (NY) MILLARD FILLMORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $1049.00 | 1588854772 - ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC | 201243484 - (AL) ALABAMA DIGESTIVE HEALTH | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $125.00 | 1659526457 - NORWOOD ENDOSCOPY CENTER, LLC | 263691316 - (OH) NORWOOD ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $983.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $511.00 | 1295287522 - MIDTOWN SURGERY CENTER | 473103507 - (GA) MIDTOWN SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $780.00 | 1154370146 - MICHIGAN SURGICAL CENTER,LLC | 383210989 - (MI) MICHIGAN SURGICAL CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $109.00 | 1972578771 - SUN CITY AZ ENDOSCOPY ASC LLC, SUN CITY ENDOSCOPY CENTER | 201519369 - (AZ) SUN CITY AZ ENDOSCOPY ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $280.00 | 1265404669 - NORTH RIVER SURGERY CENTER, LLC | 710799771 - (AR) NORTH RIVER SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $2785.00 | 1477516961 - CENTRUM SURGERY CENTER LTD | 752546712 - (CO) CENTRUM SURGERY CENTER LTD | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31380 | $275.00 | 1891728382 - MISSISSIPPI COAST ENDOSCOPY & AMBULATORY CENTER LLC, MISSISSIPPI COAST ENDOSCOPY & AMBULATORY SURGICAL | 640927074 - (MS) MISSISSIPPI COAST ENDOSCOPY AND AMBULATORY CENTER, LLC | MS | 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 31380 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31380 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 31380 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 31380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31380 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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