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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address moderate-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 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body 59 - Distinct Procedural Service 58 - Staged or related procedure during postoperative period SG - Scene to Hospital ESRD facility AS - PA/NP/CNS assistant at surgery 74 - Discontinued After Anesthesia LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31512 |
| Medicaid Fee Schedule | View Medicaid rates for 31512 |
National average reimbursement for CPT 31512 by major payers:

$249.98

$272.64

$289.81

$218.14
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Surgical Institute Of Monroe
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See a sample payer proposalCPT 31512 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31512 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 31512 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 |
|---|---|---|
| 31510-CPT | Moderate | Voice Box Exam With Biopsy, An Exam Of The Voice Box Using A Scope (Laryngoscopy). The Procedure Takes A Sample Of Tissue For Testing (Biopsy). |
| 31511-CPT | Moderate | Laryngoscopy Indirect (Separa, Laryngoscopy Indirect (Separate Procedure) With Removal Offoreign Body Laryngoscopy Indirect (Separate Procedure) With Removal Of |
| 31512-CPT | Moderate | Voice Box Surgery, Surgery Aided By A Scope (Laryngoscopy) To Remove A Growth Or Fluid Sac (Cyst) From The Voice Box. A Graft May Be Used To Reconstruct The Voice Box. |
| 31513-CPT | Low | Vocal Cord Injection, An Exam Of The Vocal Cords Using A Scope (Laryngoscopy). The Procedure Injects Medication Into The Vocal Cords. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31512. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31512 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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