CPT 31536 Fee Schedule
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.
| 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 • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 31536 by major payers:
$278.08
$282.85
$311.83
$353.10
| 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 31536 | ||||||
United | 31536 | $1400.00 | 1497745178 - SURGERY CENTER, DBA SAWTOOTH SURGERY CENTER | 823348107 - (ID) SURGERY CENTER | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $950.00 | 1497029466 - MOUNTAIN HOME SURGERY CENTER, INC. | 454157268 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $811.00 | 1326047937 - WEST SHORE ENDOSCOPY CENTER LLC | 251885828 - (PA) WEST SHORE ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $576.00 | 1477803724 - VALENCIA SPECIALTY SURGERY PC | 460979296 - (CA) VALENCIA SPECIALTY SURGERY PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $2206.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $1100.00 | 1780604694 - CLEARVIEW SURGERY CENTER INC | 202828714 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $1573.00 | 1962695122 - NORTH ORANGE COUNTY SURGERY CENTER | 260625103 - (CA) NORTH ORANGE COUNTY SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $1861.00 | 1972805299 - ST. VINCENT'S OUTPATIENT SURGERY SERVICES LLC | 200708162 - (AL) ST VINCENTS OUTPATIENT SURGERY SERVICES LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $900.00 | 1104998558 - AMERICAN EYE SURGERY CENTER, INC. | 203774302 - (GA) AMERICAN EYE SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $998.00 | 1528166113 - SOUTHERN BONE & JOINT AMBULATORY SURGICAL CENTER, LLC, SOUTHERN BONE & JOINT, LLC | 582558264 - (GA) SOUTHERN BONE JOINT AMBULATORY SURGICAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $1155.00 | 1366529638 - NGC ENDOSCOPY SERVICES LLC | 931307280 - (OR) NGC ENDOSCOPY SERVICES LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $2300.00 | 1164584066 - NAPERVILLE SURGICAL CENTRE LLC | 200433367 - (IL) NAPERVILLE SURGICAL CENTRE, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $652.00 | 1366746752 - NEW ENGLAND FERTILITY SURGICAL CENTER | 264741111 - (CT) NEW ENGLAND FERTILITY SURGICAL CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $576.00 | 1326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC | 201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31536 | $2388.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | 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 31536 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31536 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 31536 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 |
|---|---|---|
| 31535-CPT | Moderate | Laryngoscopy,Direct,Operative,W/Bx; |
| 31536-CPT | Moderate | Laryngoscopy Direct W Biopsy-Micro |
| 31540-CPT | Moderate | Laryngoscpy,Dir,Op,Exc Tum/Strp Crd |
| 31541-CPT | Moderate | Laryngoscopy, Direct, Operative, With Excision Of Tumor And/Or Stripping Of Vocal Cords Or Epiglottis; With Operating Microscope Or Telescope |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31536. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31536 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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