CPT 31640 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 • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31640 |
National average reimbursement for CPT 31640 by major payers:
$334.66
$342.52
$365.78
$419.74
| 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 31640 | ||||||
United | 31640 | $1948.00 | 1346317039 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (PALM BEACH BASCOM PALMER - ASC) | 592579938 - UNIVERSITY OF MIAMI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $2100.00 | 1225523970 - BURNSVILLE SURGERY CENTER, P.A. | 830965169 - (MN) BURNSVILLE SURGERY CENTER PA | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $3166.00 | 1093731101 - EAST BRUNSWICK SURGERY CENTER LLC, UNIVERSITY SURGICENTER | 20593133 - (NJ) EAST BRUNSWICK SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1893.00 | 1104373315 - BRENTWOOD SURGERY CENTER, LLC, BRENTWOOD SURGERY CENTER | 200533890 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $3347.00 | 1548203888 - NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC, THE ORTHOPEDIC SURGERY CENTER OF ARIZONA | 202684773 - (AZ) NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1430.00 | 1053933952 - GASTROENTEROLOGY ASSOCIATES OF THE PIEDMONT, P.A., KERNERSVILLE ENDOSCOPY CENTER | 561251665 - (NC) GASTROENTEROLOGY ASSOCIATES OF THE PIEDMONT, PA | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1769.00 | 1982211728 - FT SCOTT SURGERY CENTER LLC | 853127325 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $2100.00 | 1780076885 - MURRELLS INLET ASC LLC, CAROLINA COAST SURGERY CENTER | 454450466 - (SC) MURRELLS INLET ASC, LLC DBA CAROLINA COAST SURGERY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1699.00 | 1841711942 - MACON VASCULAR CARE, LLC | 320415161 - (GA) MACON VASCULAR CARE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1562.00 | 1437113206 - ORLANDO SURGICARE LTD | 752375604 - (FL) ORLANDO SURGICARE LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1500.00 | 1598372963 - ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC | 853147678 - (GA) ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1624.00 | 1992794580 - VALLEY MEDICAL PLAZA AMBULATORY | 731718858 - (CA) VALLEY MEDICAL PLAZA AMBULATORY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $3623.00 | 1548241623 - GASTROENTEROLOGY ASSOCIATES, LLC, GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER | 912104493 - (WA) GASTROENTEROLOGY ASSOCIATES PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $1826.00 | 1558327213 - SURGICARE OF JACKSON LTD | 752162993 - (MS) SURGICARE OF JACKSON LTD | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31640 | $2490.00 | 1689986879 - DEER POINTE SURGICAL CENTER, LLC, POA SURGERY CENTER | 272384315 - (MD) DEER POINTE SURGICAL 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 31640 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31640 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 31640 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 |
|---|---|---|
| 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 |
| 31636-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Placement Of Bronchial Stent(S) (Includes Tracheal/Bronchial Dilation As Required), Initial Bronchus |
| 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) |
| 31640-CPT | Moderate | Bronchoscopy W Excision Tumor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31640 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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