CPT 31630 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 • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31630 |
National average reimbursement for CPT 31630 by major payers:
$279.37
$270.76
$294.90
$333.52
| 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 31630 | ||||||
United | 31630 | $3347.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $3570.00 | 1760486369 - MOUNTAIN EMPIRE SURGERY CENTER LP | 621772667 - (TN) MOUNTAIN EMPIRE SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $4140.00 | 1245798826 - SURGCENTER OF GREATER DALLAS, LLC., SURGCENTER OF GREATER DALLAS | 831498677 - (TX) SURGCENTER OF GREATER DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $3976.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $1980.00 | 1407023161 - SOUTHWEST MINNESOTA SURGICAL CENTER, INC. | 261451498 - (MN) SOUTHWEST MINNESOTA SURGICAL CENTER INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $5310.00 | 1477017648 - CONNECTICUT ORTHOPAEDIC SURGERY CENTER, LLC | 832570191 - (CT) CONNECTICUT ORTHOPAEDIC SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $3500.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $3623.00 | 1548217128 - GULFSHORE ENDOSCOPY CENTER LLC | 650615196 - (FL) GULFSHORE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $2307.00 | 1558564344 - SURGERY CENTER OF ATLANTIS LLC | 260298828 - (FL) SURGERY CENTER OF ATLANTIS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $1211.00 | 1295739217 - WATERSIDE AMBULATORY SURGICAL CENTER LLC | 650270415 - (FL) WATERSIDE AMBULATORY SURGICAL CE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $1227.00 | 1598804486 - SHREVEPORT SURGERY CENTER PTRSHP | 721126552 - (LA) SHREVEPORT SURGERY CENTER OF CADDO PARISH, INC. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $643.00 | 1508054818 - CUMMINS WOMENS HEALTHCARE LLC, ELIZABETH CUMMINS MD | 522110421 - (OH) CUMMINS WOMENS HEALTHCARE, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $1500.00 | 1174568810 - SURGICAL CARE CENTER, INC. | 351640392 - (IN) SURGICAL CARE CENTER INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $4140.00 | 1811995913 - DALLAS SURGICAL PARTNERS, LLC, BAYLOR SCOTT & WHITE SURGICARE | 752813815 - (TX) DALLAS SURGICAL PARTNERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31630 | $1683.00 | 1881002343 - INNOVATIVE SURGERY CENTER, LLC | 471395981 - (MD) INNOVATIVE SURGERY CENTER LLC | 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 31630 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31630 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 31630 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 With Brushing Or Protected Brushings |
| 31624-CPT | Moderate | Bronchoscopy With Bronchial Alveolar Lavage |
| 31627-CPT | High | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Computer-Assisted, Image-Guided Navigation (List Separately In Addition To Code For Primary Procedure(S)) |
| 31630-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Tracheal/Bronchial Dilation Or Closed Reduction Of Fracture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31630 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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