CPT 31643 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 • GK |
| Complexity Level | Moderate |
National average reimbursement for CPT 31643 by major payers:
$248.15
$234.87
$242.63
$287.30
| 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 31643 | ||||||
United | 31643 | $365.00 | 1124443809 - POOLE ENDOSCOPY CENTER, LLC | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $1528.00 | 1891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY | 611917634 - (FL) ADVANCED CENTER FOR SURGERY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $527.00 | 1528622321 - PREMIER-COVENANT ASTC LLC, PREMIER AMBULATORY SURGERY CENTER | 834550993 - (TN) PREMIERCOVENANT ASTC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $1276.00 | 1497165179 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF PHOENIX | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $800.00 | 1922438472 - PARK AMBULATORY SURGERY CENTER, LLC | 463665760 - (TX) PARK AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $425.00 | 1487742680 - NOVAMED SURGERY CENTER OF CLEVELAND LLC, THE SURGERY CENTER OF CLEVELAND | 205493062 - (TN) NOVAMED SURGERY CENTER OF CLEVELAND LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $521.00 | 1619965324 - ADVANCED SURGERY CENTER LLC | 20669696 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $725.00 | 1316678311 - OPTUM PEAK ENDOSCOPY CENTER LLC | 880934943 - (CO) OPTUM PEAK ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $890.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $1591.00 | 1669705034 - EYE SPECIALISTS SURGERY CENTERS, LLC, MUNCIE SURGICAL CARE CENTER | 270927202 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $1438.00 | 1942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC | 823193901 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $799.00 | 1730687179 - MULTICARE HEALTH SYSTEM, MULTICARE ROCKWOOD EYE SURGERY CENTER | 911352172 - MULTICARE HEALTH SYSTEM | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $947.00 | 1922660109 - BANNER SURGERY CENTER | 842157389 - (AZ) BANNER SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $582.00 | 1487657862 - FILLMORE EYE CLINIC INCORPORATED, FILLMORE EYE CLINIC ASC | 272444464 - (NM) FILLMORE EYE CLINIC, INC. | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31643 | $1258.00 | 1942851639 - NORTHERN MICHIGAN SURGICAL SUITES, LLC | 830670803 - (MI) NORTHERN MICHIGAN SURGICAL SUITES, LLC | MI | 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 31643 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31643 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 31643 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 |
| 31640-CPT | Moderate | Bronchoscopy W Excision Tumor |
| 31641-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Destruction Of Tumor Or Relief Of Stenosis By Any Method Other Than Excision (Eg, Laser Therapy, Cryotherapy) |
| 31643-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluorscopic Guidance, When Performed; Diagnostic, With Placement Of Catheter(S) For Intacavitary Radioelement Application |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31643. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31643 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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