CPT 31646 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31646 |
National average reimbursement for CPT 31646 by major payers:
$262.17
$263.72
$267.76
$277.05
| 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 31646 | ||||||
United | 31646 | $44.00 | 1306486634 - FREDERICKSBURG ENDOSCOPY CENTER, LLC | 834398314 - (VA) FREDERICKSBURG ENDOSCOPY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $256.26 | 1649547712 - OMAR RIVERA-RIVERA | 350593390 - DEACONESS HOSPITAL INC | PR | Family Medicine Physician (207Q00000X) |
United | 31646 | $394.00 | 1871513705 - SQUAW PEAK SURGICAL FACILITY INC | 860889294 - (AZ) SQUAW PEAK SURGICAL FACILITY INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $882.00 | 1952874182 - SAME DAY SC OF CENTRAL NJ LLC | 831832261 - (NJ) SAME DAY SC OF CENTRAL NJ LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $864.00 | 1780331769 - ASC SURGICAL VENTURES, LLC | 351995261 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $256.26 | 1548557721 - JASON BOOTH | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 31646 | $688.00 | 1346237328 - VICTORIA AMBULATORY SURGERY CENTER, LP, THE SURGERY CENTER | 352240144 - (TX) VICTORIA AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $90.00 | 1639386659 - MIDWEST EYE CONSULTANTS, P.C., CLI SURGERY CENTER | 351845786 - (IN) MIDWEST EYE CONSULTANTS, P.C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $907.00 | 1134183908 - NORTH PALM BEACH COUNTY SURGERY CENTER LLC | 752424900 - (FL) NORTH PALM BEACH COUNTY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $1103.00 | 1669748125 - RIVERVIEW SURGERY CENTER LLC | 452951941 - (IN) RIVERVIEW SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $500.00 | 1912909169 - KIPS BAY ENDOSCOPY CENTER, LLC | 134243635 - (NY) KIPS BAY ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $256.26 | 1063823193 - HENDY JEAN | 350593390 - DEACONESS HOSPITAL INC | IN | Internal Medicine Physician (207R00000X) |
United | 31646 | $113.00 | 1578643607 - PAIN CENTER LLC | 331048492 - (AR) THE PAIN CENTER OF JONESBORO, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $70.00 | 1720161771 - EYE CARE SURGERY CENTER OF OLIVE BRANCH,LLC | 470920340 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $191.00 | 1831217231 - THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | 205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | OH | 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 31646 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31646 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 31646 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 |
|---|---|---|
| 31643-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluorscopic Guidance, When Performed; Diagnostic, With Placement Of Catheter(S) For Intacavitary Radioelement Application |
| 31645-CPT | Moderate | Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed; With Therapeutic Aspiration Of Tracheobronchial Tree Initial. (Desc Revised 1/1/2018) |
| 31646-CPT | Moderate | Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed; With Therapeutic Aspiration Of Tracheobronchial Tree Subsequent Same Hospital Stay (Desc Revised 1/1/2018) |
| 31647-CPT | Moderate | Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed; With Balloon Occlusion, When Performed, Assessment Of Air Leak, Airway Sizing, And Insertion Of Bronchial Valve(S), Initial Lobe |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31646. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31646 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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