CPT 31649 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 • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 31649 by major payers:
$101.67
$95.66
$94.67
$123.82
| 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 31649 | ||||||
United | 31649 | $579.00 | 1437736071 - SCENT ASC OPPORTUNITY FUND LLC, SCENT SURGICAL CENTER | 862520870 - (SC) SCENT ASC OPPORTUNITY FUND LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $1981.00 | 1811101439 - SENTARA OBICI AMBULATORY SURGERY, LLC | 260144898 - (VA) SENTARA OBICI AMBULATORY SURGERY, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $578.00 | 1972831998 - SAN DIEGO SKIN, INC. | 203245033 - (CA) SAN DIEGO SKIN, INC M MARK MOFID MD APC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $721.00 | 1730382789 - ENDOSCOPY CENTER | 260317060 - (NC) ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $3188.00 | 1023359627 - THE EMORY CLINIC INC., EMORY AESTHETIC CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $1233.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $670.00 | 1356890172 - DIALYSIS ACCESS SERVICES, LLC | 472322456 - (MD) DIALYSIS ACCESS SERVICES LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $480.00 | 1396192241 - ANDERSON ENDOSCOPY CENTER LLC | 811947476 - (OH) ANDERSON ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $1817.00 | 1861766016 - HAYS SURGERY CENTER, LLC | 274579547 - (TX) HAYS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $579.00 | 1811534555 - MIDLANTIC UROLOGY SURGERY CENTER, LLC | 825347080 - (PA) MIDLANTIC UROLOGY SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $475.00 | 1275199978 - RAC SURGERY CENTER LLC | 831302565 - (NC) RAC SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $1714.00 | 1942397104 - PREMIER ENDOSCOPY, LLC | 50599351 - (NJ) PREMIER ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $575.00 | 1750456539 - WIREGRASS RANCH ASC HOLDINGS, WIREGRASS RANCH AMBULATORY SURGERY CENTER | 991010158 - (FL) WIREGRASS RANCH ASC HOLDINGS | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $605.00 | 1972578771 - SUN CITY AZ ENDOSCOPY ASC LLC, SUN CITY ENDOSCOPY CENTER | 201519369 - (AZ) SUN CITY AZ ENDOSCOPY ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31649 | $1526.00 | 1720606932 - PHYSICIANS CLINIC INC | 470687317 - PHYSICIANS CLINIC INC | NE | 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 31649 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31649 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 31649 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 |
|---|---|---|
| 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 |
| 31649-CPT | Low | Bronchoscopy Rigid Or Flexible Including Fluoro-Scopic Guidance When Performed; With Removal Of Bronchial Valve(S) Each Additional Lobe (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31649. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31649 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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