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See a sample rate comparisonCPT 31601 Fee Schedule
Last Verified: October 2026
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.
Create Opening In Airway, Surgery On A Child Younger Than Age Two To Create An Opening Into The Windpipe For Breathing. Skin Flaps May Be Used To Close The Opening.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None GC - Service performed by resident under supervision AG - Primary physician 63 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31601 |
| Medicaid Fee Schedule | View Medicaid rates for 31601 |
National average reimbursement for CPT 31601 by major payers:
$482.38
$488.68
$556.57
$643.88
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CPT 31601
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Cleburne
$6,245.00Published rateAdventhealth Surgery Center Davenport LLC
$2,353.00Published rateSouth Portland Surgical Center LLC, South Portland Surgical Center
South Portland Surgical Center, LLC
$1,822.00Published rateNorth Pacific Dermatology Ps
$1,325.00Published rateWaterside Ambulatory Surgical Center LLC
Waterside Ambulatory Surgical Ce
$698.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 31601 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31601 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 31601 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 |
|---|---|---|
| 31600-CPT | Moderate | Create Opening In Airway, Surgery To Create An Opening Into The Windpipe (Trachea) For Breathing. Skin Flaps May Be Used To Close The Opening. |
| 31601-CPT | Moderate | Create Opening In Airway, Surgery On A Child Younger Than Age Two To Create An Opening Into The Windpipe For Breathing. Skin Flaps May Be Used To Close The Opening. |
| 31605-CPT | Moderate | Tracheostomy Emergency Proced, Tracheostomy Emergency Procedure Cricothyroid Membranetracheostomy Emergency Procedure Cricothyroid Membrane |
| 31611-CPT | Moderate | Construction Of Tracheoesophag, Construction Of Tracheoesophageal Fistula And Subsequentinsertion Of An Alaryngeal Speech Prosthesis(Eg Voice Button Blom-Singer Prosthesis) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31601. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31601 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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