CPT 31554 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 • 22 - Increased Procedural Services • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31554 |
National average reimbursement for CPT 31554 by major payers:
$2,138.59
$2,243.62
$2,316.98
$2,812.07
| 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 31554 | ||||||
United | 31554 | $790.00 | 1780923128 - MACOMB ENDOSCOPY CENTER PLC | 275015226 - (MI) MACOMB ENDOSCOPY CENTER PLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $2974.00 | 1124026422 - CHARLESTON ENT ASSOCIATES, LLC, SURGERY CENTER OF CHARLESTON | 582281023 - (SC) CHARLESTON ENT ASSOCIATES, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $2034.00 | 1265486849 - FEATHERSTONE PARTNERSHIP LP, ROCKFORD AMBULATORY SURGERY CENTER | 363861021 - (IL) THE FEATHERSTONE PARTNERSHIP L. P. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $710.00 | 1306956818 - WASHBURN SURGERY CENTER, LLC | 752748654 - (KS) WASHBURN SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $1215.00 | 1578881009 - EYE LASER AND SURGERY CENTER LLC | 272376757 - (OH) EYE LASER AND SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $3320.00 | 1215900246 - SUNRISE OPHTHALMOLOGY ASC LLC, FOUNDATION FOR ADVANCED EYE CARE | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $2420.00 | 1538549852 - BAKERSFIELD SPECIALISTS SURGICAL CENTER, LLC | 465765998 - (CA) BAKERSFIELD SPECIALISTS SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $5020.00 | 1811515034 - SALMON SURGERY CENTER LLC | 844895716 - (WA) SALMON SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $874.00 | 1114926714 - ENDOSCOPY CENTER OF DAYTON LTD | 311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $1816.00 | 1790710390 - SOUTHWESTERN MEDICAL CENTER, LLC, MAGNA SURGICAL CENTER | 364212258 - (IL) SOUTHWESTERN MEDICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $3500.00 | 1538280284 - PHYSICIANS SURGERY CENTER OF MODESTO INC, RIVER SURGICAL INSTITUTE | 201088433 - (CA) PHYSICIANS SURGERY CENTER OF MODESTO DBA RIVER SURGICAL INSTITUTE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $2500.00 | 1154593481 - RANCHO MIRAGE SURGERY CENTER, LLC, RANCHO MIRAGE SURGERY CENTER | 262136928 - (CA) RANCHO MIRAGE SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $846.00 | 1821166521 - PHYSICIANS SURGERY CENTER LLC | 860936521 - (AZ) PHYSICIANS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $743.00 | 1427078930 - RETINA CONSULTANTS SURGERY CENTER | 223314785 - (NJ) RETINA CONSULTANTS SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31554 | $2700.00 | 1316342579 - ENCINO SURGICAL CENTER LLC | 471132992 - (CA) ENCINO SURGICAL CENTER LLC | CA | 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 31554 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31554 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 31554 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 31554. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31554 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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