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See a sample rate comparisonCPT 31528 Fee Schedule
Last Verified: October 2026
Healthcare 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.
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.
| 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 51 - Multiple procedures GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 31528 |
| Medicaid Fee Schedule | View Medicaid rates for 31528 |
National average reimbursement for CPT 31528 by major payers:
$185.68
$191.91
$216.07
$237.60
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CPT 31528
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes-Gi Diagnostics LLC
Saint Lukesgi Diagnostics LLC
$4,826.00Published rateAtlanticare Surgery Center LLC
$1,800.00Published rateFranciscan Medical Group, The Doctors Clinic Ambulatory Surgical Center, A Part Of The Francisca
Franciscan Medical Group
$1,167.00Published ratePeachtree Orthopaedic Surgery Center-North, LLC
Peachtree Orthopaedic Surgery Centernorth LLC
$1,075.00Published rateAndrea Infantino
Deaconess Hospital Inc
$116.52Published rate
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See a sample payer proposalCPT 31528 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31528 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 31528 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 |
|---|---|---|
| 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. |
| 31530-CPT | Moderate | Remove Object From Voice Box, An Exam Of The Voice Box Using A Scope (Laryngoscope). The Procedure Removes A Foreign Object From The Voice Box. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31528. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31528 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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