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 |
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 | $115.00 | 1457448912 - GLADIOLUS SURGERY CENTER , LLC | 651025514 - (FL) GLADIOLUS SURGERY CENTER L L C | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $566.00 | 1841251501 - ST AUGUSTINE ENDOSCOPY CENTER LLC | 592947745 - (FL) ST AUGUSTINE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $1160.00 | 1942722798 - DREXEL TOWN SQUARE SURGERY CENTER, LLC, DREXEL TOWN SQUARE SURGERY CENTER | 814904300 - (WI) DREXEL TOWN SQUARE SURGERY CENTER LLC | WI | 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 | $79.00 | 1366681355 - SALINA SURGICAL ARTS CENTER, LLC, DAVID A. HENDRICK M.D., P.A. | 208824691 - (KS) DAVID A. HENDRICK MD | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 | $1096.00 | 1336437482 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | 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 | $458.00 | 1639135346 - SURGERY CENTERS OF DES MOINES LTD | 363562598 | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $1029.00 | 1285976183 - TEXAS HEALTH FLOWER MOUND ORTHOPEDIC SURGERY CENTER LLC | 800866449 - (TX) TEXAS HEALTH FLOWER MOUND ORTHOPEDIC SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $256.26 | 1861694259 - HARSHIT MODI | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 31646 | $256.26 | 1861840779 - JESSICA TRIMER | 350593390 - DEACONESS HOSPITAL INC | WV | Certified Registered Nurse Anesthetist (367500000X) |
United | 31646 | $627.00 | 1568979805 - ST DAVIDS AUSTIN AREA ASC LLC, ST . DAVID'S AUSTIN SURGERY CENTER | 611760247 - (TX) ST DAVIDS AUSTIN AREA ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $502.00 | 1134665193 - NHPE, LLC, NEW HYDE PARK ENDOSCOPY | 471158058 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31646 | $350.00 | 1225077241 - CORTEZ FOOT SURGERY CENTER, P.A. | 650064196 - (FL) CORTEZ FOOT SURGERY CENTER PA | FL | 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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