CPT 31638 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 31638 |
National average reimbursement for CPT 31638 by major payers:
$332.93
$335.53
$350.29
$423.69
| 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 31638 | ||||||
United | 31638 | $3570.00 | 1598996894 - SURGICAL ELITE OF AVONDALE, LLC | 270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $874.00 | 1306199757 - SONTERRA PROCEDURE CENTER, LLC | 455125802 - (TX) SONTERRA PROCEDURE CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $1180.00 | 1215489182 - CORONADO SURGERY CENTER LLC | 814244748 - (AZ) CORONADO SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $2280.00 | 1386647402 - PHYSICIANS DAY SURGERY CENTER, LLC, PHYSICIANS DAY SURGERY CENTER, INC. | 593438026 - (FL) PHYSICIANS DAY SURGERY CENTER, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $2000.00 | 1689326670 - PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC, PRISMA HEALTH ORTHOPEDIC SURGERY CENTER | 873101776 - (SC) PRISMA HEALTH AMBULATORY SURGERY CENTERSMIDLANDS LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $6342.00 | 1538104724 - FORT WORTH ENDOSCOPY CENTERS, LLC, SOUTHWEST FORT WORTH ENDOSCOPY CENTER | 770368346 - (TX) FORT WORTH ENDOSCOPY CENTERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $2142.00 | 1386898435 - COLUMBIA GORGE SURGERY CENTER, LLC | 261819228 - (OR) COLUMBIA GORGE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $759.00 | 1003888710 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $2500.00 | 1154959179 - MUNSTER SURGERY CENTER LLC | 844828519 - (IN) MUNSTER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $3500.00 | 1184125809 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $2799.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $2265.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $6410.00 | 1740236454 - PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT LLC, PRINCESS ANNE AMBULATORY SURGERY CENTER | 204920880 - (VA) PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $6904.00 | 1366776106 - MEMORIAL HERMANN SURGERY CENTER RICHMOND, LLC, MEMORIAL HERMANN SURGERY CENTER RICHMOND | 270552583 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31638 | $2010.00 | 1033773023 - VISION PARK SURGERY CENTER, LLC | 832719581 - (TX) VISION PARK SURGERY CENTER LLC | TX | 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 31638 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31638 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 31638 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) |
| 31633-CPT | Low | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Transbronchial Needle Aspiration Biopsy(S), Each Additional Lobe (List Separately In Addition To Code For Primary Procedure) |
| 31634-CPT | High | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Balloon Occlusion, With Assessment Of Air Leak, With Administration Of Occlusive Substance (Eg, Fibrin Glue), If Performed |
| 31638-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Revision Of Tracheal Or Bronchial Stent Inserted At Previous Session (Includes Tracheal/Bronchial Dilation As Required) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31638. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31638 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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