CPT 31580 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 52 - Reduced Services • AG - Primary physician • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31580 |
National average reimbursement for CPT 31580 by major payers:
$1,539.20
$1,621.90
$1,733.65
$2,099.20
| 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 31580 | ||||||
United | 31580 | $5122.22 | 1003807835 - LAKEVIEW SURGERY CENTER LC | 421516120 - (IA) LAKEVIEW SURGERY CENTER LC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $4459.00 | 1255339628 - BISMARCK SURGICAL ASSOCIATES, LLC | 450450254 - (ND) BISMARCK SURGICAL ASSOCIATES LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $3253.00 | 1699711382 - TOWSON SURGICAL CENTER LLC, TOWSON SURGICAL CENTER | 521945958 - (MD) TOWSON SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $2392.00 | 1912158684 - SURGCENTER OF BEL AIR | 262215322 - (MD) SURGCENTER OF BEL AIR, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $3448.00 | 1548296296 - ENT SURGERY CENTER OF AUGUSTA, LLC | 20577882 - (GA) ENT SURGERY CENTER OF AUGUSTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $1228.00 | 1548655053 - MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER, LLC | 640884577 - (MS) MISSISSIPPI UROLOGY CLINIC, PLLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $1420.00 | 1669437109 - MARIETTA OUTPATIENT SURGERY, LTD | 752160466 - (GA) MARIETTA OUTPATIENT SURGERY LTD | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $3000.00 | 1952912552 - SURGERY CENTER OF NORTH CENTRAL OHIO LLC, THE SURGERY CENTER OF NORTH CENTRAL OHIO | 833986181 - (OH) THE SURGERY CENTER OF NORTH CENT | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $2913.00 | 1336112200 - MERCER COUNTY SURGERY CENTER LLC, MERCER COUNTY SURGERY CENTER | 223774069 - (NJ) MERCER COUNTY SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $1090.00 | 1578535233 - SUN CITY OPHTHALMOLOGY ASC LLC, EYE INSTITUTE AT BOSWELL | 621737549 - (AZ) SUN CITY OPHTHALMOLOGY ASSOC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $1907.00 | 1962963728 - VISIONARY SURGERY CENTER OF NEVADA, LLC | 832017500 - (NV) VISIONARY SURGERY CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $3301.00 | 1588620306 - SPECIALTY ORTHOPAEDICS SURGERY CENTER | 201170147 - (GA) SPECIALTY ORTHOPAEDICS SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $1690.00 | 1538122684 - KISSIMMEE SURGICARE LTD | 752407306 - (FL) KISSIMMEE SURGICARE LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $1244.00 | 1710591060 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC | 272910652 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31580 | $5257.00 | 1609907211 - SHREWSBURY SURGERY CENTER, LLC, SHREWSBURY SURGERY CENTER | 223651945 - (NJ) SHREWSBURY SURGERY CENTER LLC | 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 31580 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31580 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 31580 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 |
| 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 31580. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31580 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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