CPT 31623 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 31623 by major payers:
$372.04
$386.92
$421.04
$459.54
| 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 31623 | ||||||
United | 31623 | $549.00 | 1528622321 - PREMIER-COVENANT ASTC LLC, PREMIER AMBULATORY SURGERY CENTER | 834550993 - (TN) PREMIERCOVENANT ASTC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $1955.00 | 1649793613 - BAYLOR SURGICARE AT BLUE STAR, LLC | 812931756 - (TX) BAYLOR SURGICARE AT BLUE STAR LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $1438.00 | 1386161495 - MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC | 820985178 - (MD) MEDSTAR SURGERY CENTER AT BRAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $558.00 | 1245399757 - KUMAR SURGICAL CENTER LLC | 383530839 - (MI) KUMAR SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $3022.00 | 1306472063 - THE EMORY CLINIC INC, EMORY ENDOSCOPY CENTER AT DECATUR | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $364.00 | 1548655053 - MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER, LLC | 463162562 - (MS) MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $749.00 | 1992765986 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, WALDRON ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $2400.00 | 1750303855 - MEADOWS SURGERY CENTER, LLC, MEADOWS SURGERY CENTER | 200181381 - (NJ) MEADOWS SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $500.00 | 1548844384 - GUT ENDO, LLC, CENTER FOR DIGESTIVE HEALTH | 834462225 - (AL) GUT ENDO, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $1056.00 | 1588801377 - CHILDREN'S NORTH SURGERY CENTER, LLC | 262394578 - (CO) CHILDRENS HOSPITAL NORTH SURGE | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $885.00 | 1871674481 - CAROLINAS PHYSICIANS NETWORK INC, ATRIUM HEALTH ENDOSCOPY CENTER BALLANTYNE | 561667838 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $544.00 | 1386616050 - INDEPENDENCE ASC LLC, THE ENDOSCOPY CENTER - NORTH | 621707564 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $1233.00 | 1205023280 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $332.00 | 1912018086 - CENTER FOR ENDOSCOPY INC | 651010956 - (FL) CENTER FOR ENDOSCOPY INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31623 | $1179.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | 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 31623 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31623 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 31623 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 |
|---|---|---|
| 31622-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; Diagnostic, With Cell Washing, When Performed (Separate Procedure) |
| 31623-CPT | Moderate | Bronchoscopy With Brushing Or Protected Brushings |
| 31624-CPT | Moderate | Bronchoscopy With Bronchial Alveolar Lavage |
| 31625-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Bronchial Or Endobronchial Biopsy(S), Single Or Multiple Sites |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31623. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31623 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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