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CPT 31395 Fee Schedule

Last Verified: January 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.

Pharyngolaryngectomy,With Rad.Neck Disse
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Respiratory System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

22 - Increased Procedural Services

GC - Service performed by resident under supervision

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 31395

National average reimbursement for CPT 31395 by major payers:

bcbs

$3,554.72

uhc

$3,864.93

aetna

$4,110.93

cigna

$4,856.32

Preview provider-level rates for...
For billing codeCPT 31395
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 31395

United
31395$565.001619221801 - ASC DEVELOPMENT COMPANY, LLC203405773 - (MD) ASC DEVELOPMENT COMPANY LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$425.001093395501 - COLUMBUS ONE ENDOSCOPY LLC, HILLIARD ENDO CENTER824347730 - (OH) COLUMBUS ONE ENDOSCOPY LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$916.001043391188 - SKIN SURGERY CENTER PS, SKIN SURGERY CENTER911954101 - (WA) SKIN SURGERY CENTER P. S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$5554.001407165772 - MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY, LLC, MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY273520409TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$648.001831846369 - OPHTHALMIC SURGERY CENTER, LLC874648478 - (KY) OPHTHALMIC SURGERY CENTER LLCKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$1124.001174185649 - PISA ASC HOLDCO LLC, PAIN INSTITUTE OF SOUTHERN ARIZONA PROCEDURE CENTER831944129 - (AZ) PISA ASC HOLDCO LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$1607.001639261365 - SPECIALISTS ONE- DAY SURGERY LLC, SPECIALISTS ONE-DAY SURGERY161601940 - (NY) SPECIALISTS ONE DAY SURGERY LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$138.001487628301 - SAN ANTONIO TX ENDOSCOPY ASC LP, SAN ANTONIO GASTROENTEROLOGY ENDOSCOPY CENTER200075829 - (TX) SAN ANTONIO TX ENDOSCOPY ASC LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$2377.001114291440 - PREMIER ASC LLC, PREMIER ORTHOPAEDIC SURGERY CENTER352433859TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$750.001568814010 - SURGERY CENTER OF CALIFORNIA -LLC812978830 - (CA) SURGERY CENTER OF CALIFORNIA LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$500.001881658524 - CUMBERLAND VALLEY SURGERY CENTER, LLC753079478 - (MD) CUMBERLAND VALLEY SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$350.001720270879 - AKSTEIN EYE CENTER, ASC, AKSTEIN EYE CENTER, ASC581597344 - (GA) AKSTEIN EYE CENTER PCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$954.001376164475 - ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP, RIDGEWOOD ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO742976746 - (TX) ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$497.001528024114 - AMBULATORY CARE CENTER PA223479837 - (NJ) AMBULATORY CARE CENTER PANJAmbulatory Surgical Clinic/Center (261QA1903X)
United
31395$4300.001669465209 - FOUNDATION SURGERY AFFILIATE OF HUNTINGDON VALLEY LP, HUNTINGDON VALLEY SURGERY CENTER680499459 - (PA) FOUNDATION SURGERY AFFILIATE OF HUNTINGDON VALLEYPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 31395 vs. Other Surgical Procedures on the Respiratory System Codes

The CPT 31395 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 31395 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.

CodeComplexityDescription
31368-CPTHighLaryngectomy;Subtot.Supraglottic,W Rad N
31370-CPTHighHemilaryngectomy Horizontal
31382-CPTHighHemilaryngectomy Ant-Lat-Vertical
31395-CPTHighPharyngolaryngectomy,With Rad.Neck Disse

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31395. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 31395 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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