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See a sample rate comparisonCPT 31610 Fee Schedule
Last Verified: October 2026
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.
Create Opening In Airway, Surgery To Create An Opening Into The Windpipe (Trachea) 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 23 - Emergency Room |
| Common Modifiers | None GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31610 |
| Medicaid Fee Schedule | View Medicaid rates for 31610 |
National average reimbursement for CPT 31610 by major payers:
$1,111.86
$1,114.14
$1,252.16
$1,450.62
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CPT 31610
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC, Aurora Pleasant Prairie Ambulatory Surgery Center
Aurora Surgery Centers LLC
$7,169.00Published ratePhysicians Surgicenter LLC
Physicians' Surgicenter, LLC
$2,814.00Published rateTexoma Valley Surgery Center Lp
$1,900.00Published rateCataract And Laser Center LLC
$1,200.00Published rateTennessee Pain Surgery Center, LLC
Tennessee Pain Surgery Center LLC
$586.00Published rate
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See a sample payer proposalCPT 31610 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31610 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 31610 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. |
| 31610-CPT | High | Create Opening In Airway, Surgery To Create An Opening Into The Windpipe (Trachea) For Breathing. Skin Flaps May Be Used To Close The Opening. |
| 31613-CPT | Moderate | Redo Surgery To Open Airway, Surgery To Repair An Opening Into The Airway Created By A Previous Surgery. The Procedure Can Include Making A New Skin Flap And Removing Excess Scar Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31610. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31610 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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