CPT 31553 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 • 58 - Staged or related procedure during postoperative period • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31553 |
National average reimbursement for CPT 31553 by major payers:
$2,027.62
$2,188.90
$2,291.32
$2,764.96
| 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 31553 | ||||||
United | 31553 | $4132.00 | 1922255413 - TWIN CITIES AMBULATORY SURGERY CENTER LP, TWIN CITIES SURGERY CENTER | 260839397 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $1626.00 | 1285690073 - BIRMINGHAM OUTPATIENT SURGERY CENTER LTD, OUTPATIENT CARECENTER | 630984076 - (AL) BIRMINGHAM OUTPATIENT SURGERY CENTER LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $2861.00 | 1760931349 - SF NASSAU ASC LLC | 300870382 - (NY) SF NASSAU ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $5354.00 | 1316947609 - AMARILLO ENDOSCOPY CENTER, LP | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $1070.00 | 1396069902 - SOUTHERN IDAHO SURGERY CENTER PLLC | 451149795 - (ID) SOUTHERN IDAHO SURGERY CENTER PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $2200.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $4100.00 | 1730698374 - ADVANCED SURGICAL CENTER OF SUNSET HILLS LLC | 821806934 - (MO) ADVANCED SURGICAL CENTER OF SUNSET HILLS, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $4800.00 | 1639694797 - UCSD CENTER FOR SURGERY OF ENCINITAS, L.P. | 822326631 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $8825.00 | 1427491547 - MEMORIAL HERMANN TEXAS INTERNATIONAL ENDOSCOPY CENTER, LLC, TEXAS INTERNATIONAL ENDOSCOPY CENTER | 462464605 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $6367.00 | 1710931860 - GRASS VALLEY SURGERY CENTER, LLC | 272185264 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $2365.00 | 1831368356 - VERMONT EYE SURGERY & LASER CENTER | 204872230 - (VT) VERMONT EYE SURGERY & LASER CENTER, LLC 401(K) PLAN | VT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $2444.00 | 1467844068 - WEST ANNAPOLIS SURGERY CENTER, LLC | 472474153 - (MD) WEST ANNAPOLIS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $3690.00 | 1447320213 - FREEHOLD ENDOSCOPY ASSOCIATES, LLC, ENDOSCOPY CENTER OF MONMOUTH COUNTY | 841634126 - (NJ) FREEHOLD ENDOSCOPY ASSOCIATES | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $3700.00 | 1306556907 - THE VANCOUVER CLINIC INC PS, SALMON CREEK 2 AMBULATORY SURGERY CENTER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31553 | $7121.00 | 1487039517 - KC PAIN ASC, LLC | 464510621 - (MO) KC PAIN ASC LLC | MO | 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 31553 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31553 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 31553 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 |
|---|---|---|
| 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 |
| 31580-CPT | High | Laryngoplasty; For Laryngeal Web With Indwelling Keel Or Stent Insertion. (Desc Revised 1/1/2017) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31553 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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