CPT 31572 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31572 |
National average reimbursement for CPT 31572 by major payers:
$588.26
$674.99
$730.26
$879.08
| 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 31572 | ||||||
United | 31572 | $1919.00 | 1497173801 - EHI SURGERY CENTER AUSTIN, LLC, LEGENT OUTPATIENT SURGERY - AUSTIN | 464266877 - (TX) EHI SURGERY CENTER AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $1375.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $2206.00 | 1386086411 - MARION SURGERY CENTER, LLC | 462447139 - (FL) MARION SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $778.00 | 1659360303 - ST JOHNS SURGERY CENTER LLC | 650502027 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $1369.00 | 1750905618 - RSPS FAYETTEVILLE ASC LLC, RSPS FAYETTEVILLE ASC | 851271440 - (GA) RSPS FAYETTEVILLE ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $2119.00 | 1518359181 - ARAPAHOE SURGICENTER, LLC | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $1275.00 | 1669548368 - PARK MEADOWS OUTPATIENT SURGERY, LLC | 841498341 - (CO) PARK MEADOWS OUTPATIENT SURGERY LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $2595.00 | 1285283432 - JONESBORO AMBULATORY SURGERY CENTER, LLC | 832479059 - (AR) JONESBORO AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $806.00 | 1033466933 - TOWN CENTER ASC LLC | 453062883 - (MI) TOWN CENTER ASC LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $2217.00 | 1053336602 - VIRGINIA EYE INSTITUTE INC, VIRGINIA EYE INSTITUTE SURGERY PAVILION | 541420580 - (VA) VIRGINIA EYE INSTITUTE INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $1425.00 | 1043690126 - BELLINGHAM UROLOGY GROUP, PLLC | 472435308 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $528.00 | 1336272657 - ARIZONA DIGESTIVE CENTER, P.C. | 201544723 - (AZ) ARIZONA DIGESTIVE CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $660.00 | 1780664185 - HILLMONT ASC LP, SPRINGFIELD AMBULATORY SURGERY CENTER | 621641866 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $1100.00 | 1750456539 - WIREGRASS RANCH ASC HOLDINGS, WIREGRASS RANCH AMBULATORY SURGERY CENTER | 991010158 - (FL) WIREGRASS RANCH ASC HOLDINGS | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31572 | $883.71 | 1144462797 - COLBY DORROH | 350593390 - DEACONESS HOSPITAL INC | KY | Emergency Medicine Physician (207P00000X) |
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 31572 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31572 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 31572 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 |
|---|---|---|
| 31571-CPT | Moderate | Laryngoscopy Dir Inj Voc Cord-Micro |
| 31572-CPT | Moderate | Once Per Dos Laryngoscopy, Flexible; With Ablation Or Destruction Of Lesion With Laser, Unilateral |
| 31574-CPT | High | Laryngoscopy, Flexible; With Injection(S) For Augmentation (Eg, Percutaneous, Transoral), Unilateral |
| 31576-CPT | Moderate | Laryngoscopy Flexible; With Biopsy(Ies) (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 31572. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31572 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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