What factors affect fee schedules for CPT 31625?

Factors that affect fee schedules for CPT 31625 include Medicare & Medicaid rates (government-set), Private Insurance rates (negotiated between providers and insurers), Geographic Location (costs may be higher in urban areas), and Provider Type (hospital providers may have different rates than private practice).

How does CPT 31625 compare to other respiratory surgery codes?

The CPT 31625 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. It typically involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments, leading to higher reimbursement and more detailed documentation requirements.

Where can I find Medicare rates for CPT 31625?

You can view Medicare rates for CPT 31625 by clicking the 'View Medicare rates for 31625' link on the PayerPrice webpage, which will direct you to the Medicare fee schedule lookup for 2025.

How can I find the cost for a specific medical procedure or service?

Finding the exact cost for a medical procedure or service can be complex due to variations by payer, provider, and geographic location. For general information, you might find national averages. However, for a specific, localized fee schedule based on CPT codes and your particular situation, it's recommended to use a specialized tool. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and a specific location to get relevant pricing information.

What is a CPT code and how does it relate to medical billing?

CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by physicians, hospitals, and other healthcare providers to describe the medical, surgical, and diagnostic services they provide to patients. These codes are standardized and are critical for accurate medical billing and for ensuring that healthcare services are reimbursed correctly by insurance companies and government payers like Medicare and Medicaid.

What is the role of CMS (Centers for Medicare & Medicaid Services) in determining healthcare costs?

CMS primarily administers the Medicare and Medicaid programs, and sets reimbursement rates and policies for services covered under these programs. While CMS fee schedules are publicly available, they specifically apply to Medicare and Medicaid patients. For those seeking information on private insurance costs or a broader range of fee schedules beyond government programs, CMS data might not fully reflect the negotiated rates of commercial payers. For specific situations involving various payers and locations, tools like Payerprice offer a more comprehensive lookup.

Why should I use Payerprice to look up healthcare costs instead of relying solely on CMS resources?

While CMS provides valuable fee schedule data for Medicare and Medicaid services, Payerprice offers a distinct advantage for users looking for a broader scope of pricing. Payerprice's tool allows you to search for fee schedule information using a CPT code and specific location, providing insights relevant to a wider range of payers, including commercial health insurance plans. This can give you a more accurate picture of potential costs for your specific situation, which CMS resources might not cover outside of government-sponsored programs.

How does Payerprice help me find specific fee schedule information?

Payerprice offers a dedicated fee schedule lookup tool designed to provide specific and localized cost information. To use it, you simply input the CPT code for the medical procedure or service you are interested in, along with a specific geographic location. The tool then provides relevant fee schedule data, helping you understand potential costs based on your search criteria. This makes it easier to compare prices and plan for healthcare expenses tailored to your unique needs.

CPT 31625 Fee Schedule

Q: What is CPT 31625?

CPT 31625 is a medical code used by healthcare providers to document and receive reimbursement for Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Bronchial Or Endobronchial Biopsy(S), Single Or Multiple Sites. It represents a moderate-level medical decision-making encounter.

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.

Bronchoscopy Rigid Or Flexibl, Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed With Bronchial Or Endobronchial Biopsy(S) Single Or Multiple Sites

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 59 - Distinct Procedural Service 51 - Multiple procedures
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 31625
Medicaid Fee Schedule	View Medicaid rates for 31625

National average reimbursement for CPT 31625 by major payers:

$424.42

$447.38

$499.56

$275.08

Compare published rates across providers.

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CPT 31625

5 of 25 sample ratesHigher to lower in this preview

Children'S National Ambulatory Surgery Center
Childrens Hospital
MDAmbulatory Surgical Clinic/CenterNPI 1215000997Tax ID 53-0196580
$1,790.00Published rate
Chandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center
AZAmbulatory Surgical Clinic/CenterNPI 1093086183Tax ID 45-4307241
$1,179.00Published rate
Pacific Ritz Surgery Center, LLC
Pacific Ritz Surgery Center LLC
CAAmbulatory Surgical Clinic/CenterNPI 1518423672Tax ID 82-3738789
$700.00Published rate
Harshit Modi
Deaconess Hospital Inc
INHospitalist PhysicianNPI 1861694259Tax ID 35-0593390
$594.65Published rate
Barbara Zimmer
Deaconess Hospital Inc
IDCertified Registered Nurse AnesthetistNPI 1437355377Tax ID 35-0593390
$273.22Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 31625 vs. Other Surgical Procedures on the Respiratory System Codes

The CPT 31625 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 31625 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
31623-CPT	Moderate	Bronchoscopy Rigid Or Flexibl, Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed With Brushing Or Protected Brushings
31624-CPT	Moderate	Exam Of Lung And Airway, Exam Of The Lung And Airway With A Scope (Bronchoscopy). The Procedure May Include Brushing Or Washing The Airway.
31625-CPT	Moderate	Bronchoscopy Rigid Or Flexibl, Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed With Bronchial Or Endobronchial Biopsy(S) Single Or Multiple Sites
31626-CPT	Moderate	Insert Scope Into Airway, Insertion Of A Scope (Bronchoscope) Into The Airway To Place A Contrast Material (Such As A Dye) Or A Marker (Such As Treated Cells). The Contrast Material Or Marker Highlights Specific Areas Of The Airway On Images Or Scans.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 31625 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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CPT 31625 Fee Schedule

Children'S National Ambulatory Surgery Center

Chandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center

Pacific Ritz Surgery Center, LLC

Harshit Modi

Barbara Zimmer