CPT 31552 Fee Schedule
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.
| 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 • AG - Primary physician • 76 - Repeat procedure by same physician • UB • 58 - Staged or related procedure during postoperative period • 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31552 |
National average reimbursement for CPT 31552 by major payers:
$1,785.36
$1,964.59
$2,035.50
$2,473.62
| 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 31552 | ||||||
United | 31552 | $1259.00 | 1275564346 - CEDAR OAKS SURGERY CENTER LLC | 450528697 - (MO) CEDAR OAKS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $1014.00 | 1528032711 - COLUMBIA ENDOSCOPY CENTER, LLC | 710923725 - (MO) COLUMBIA ENDOSCOPY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $1690.00 | 1538122684 - KISSIMMEE SURGICARE LTD | 752407306 - (FL) KISSIMMEE SURGICARE LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $3500.00 | 1114552338 - GEORGIA INTERVENTIONAL PAIN | 842028147 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $1125.00 | 1629173075 - THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN, PLLC, CROWNE POINT ENDOSCOPY & SURGERY CENTER | 352227535 - (MI) THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $2790.00 | 1578918124 - CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | 811657416 - (ND) CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $3300.00 | 1750844049 - FORT WORTH SURGICAL CENTER LP | 832752727 - (TX) FORT WORTH SURGICAL CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $2400.00 | 1144842394 - NATIONAL CARDIOVASCULAR SURGERY CENTER, LLC, PEAK SURGERY CENTER OF AVONDALE | 843454423 - (AZ) NATIONAL CARDIOVASCULAR SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $2848.00 | 1497314181 - OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC | 832118109 - (IL) OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $5020.00 | 1548784556 - NORTH ATLANTIC SURGICAL SUITES, LLC | 821540859 - (NH) NORTH ATLANTIC SURGICAL SUITES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $3000.00 | 1306435904 - ORTHOPAEDIC DEVELOPMENT PARTNERS LLC, ORTHOPAEDIC MEDICAL GROUP SURGERY CENTER | 851890498 - (FL) ORTHOPAEDIC DEVELOPMENT PARTNERS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $3003.00 | 1821276353 - PEND OREILLE SURGERY CENTER LLC | 300430739 - (ID) PEND OREILLE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $3000.00 | 1225023021 - ARC OF GEORGIA, LLC, PREMIER SURGERY CENTER | 621746313 - (GA) ARC OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $5966.00 | 1871032680 - OLIVE AMBULATORY SURGERY CENTER, LLC, NORTH CAMPUS SURGERY CENTER | 203834012 - (MO) OLIVE AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31552 | $1923.00 | 1336154152 - A CENTER FOR FOOT AND ANKLE SURGERY PA, THE CENTER FOR SPECIAL SURGERY OF HAWTHORNE | 223284458 - (NJ) A CENTER FOR FOOT AND ANKLE SU | NJ | 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 31552 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31552 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 31552 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 |
|---|---|---|
| 31551-CPT | High | Once Per Dos Laryngoplasty; For Laryngeal Stenosis, With Graft, W/O Indwelling Stent Placement, Younger Than 12 Yrs. Of Age |
| 31552-CPT | High | Once Per Dos Laryngoplasty; For Laryngeal Stenosis, With Graft, W/O Indwelling Stent Placement, Age 12 Yrs. Or Older |
| 31553-CPT | High | Once Per Dos Laryngoplasty; For Laryngeal Stenosis, With Graft, With Indwelling Stent Placement, Younger Than 12 Yrs. Of Age |
| 31554-CPT | High | Once Per Dos Laryngoplasty; For Laryngeal Stenosis, With Graft, With Indwelling Stent Placement, Age 12 Yrs. Or Older |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31552 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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