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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 | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 50 - Bilateral Procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31527 |
| Medicaid Fee Schedule | View Medicaid rates for 31527 |
National average reimbursement for CPT 31527 by major payers:

$256.93

$259.24

$268.86

$319.58
Choose a payer to see a sample of rates for CPT 31527.
Memorial Care Surgical Center At Orange Coast LLC
Florida Springs Surgery Center L
The Columbia Asc, LLC
Tallahassee Neurosugery Pain Management LLC
Painmds Ambulatory Surgical Center LLC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 31527 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31527 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 31527 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 |
|---|---|---|
| 31526-CPT | Moderate | Dx Laryngoscopy W Oper Scope, Laryngoscopy Direct With Or Without Tracheoscopy Diagnostic With Operating Microscope Or Telescope |
| 31527-CPT | Moderate | Insertion Of Voice Box Device, Exam Of The Voice Box With A Scope (Laryngoscopy). The Procedure Inserts A Temporary Device To Close An Opening In The Voice Box (Larynx). |
| 31528-CPT | Low | Scope Exam To Open Airway, An Exam Of The Voice Box And Airway Using A Scope (Laryngoscopy). The Procedure Enlarges Or Opens Sections That Are Narrowed Or Nearly Blocked. |
| 31529-CPT | Moderate | Scope Exam To Open Airway, An Exam Of The Voice Box And Airway Using A Scope (Laryngoscopy). The Procedure Enlarges Or Opens Sections That Are Narrowed Or Nearly Blocked. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31527. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31527 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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