CPT 31652 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • GC - Service performed by resident under supervision • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 31652 by major payers:
$1,221.32
$1,331.76
$1,596.19
$1,819.31
| 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 31652 | ||||||
United | 31652 | $2491.81 | 1972778652 - JENNINGS NESTOR | 561714318 - MOSES CONE MEDICAL SERVICES INC | NC | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $1126.19 | 1114649779 - SJC THORACIC SERVICES, LLC | 883669393 - (GA) SJC THORACIC SERVICES LLC | GA | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $2420.10 | 1588042725 - ANDY IRIZA | 471345819 - (SC) PRISMA HEALTH MEDICAL GROUP-MIDLANDS | SC | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $2162.96 | 1548540578 - EMERALD BRANCH | 570828733 - ROPER HOSPITAL INC | SC | Internal Medicine Physician (207R00000X) |
United | 31652 | $2826.65 | 1174788913 - RIA GRIPALDO | 582030692 - EMORY UNIVERSITY | SC | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $2162.96 | 1639486160 - JARED INTAPHAN | 570828733 - ROPER HOSPITAL INC | SC | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $2162.96 | 1003864521 - LANCE DAVIS | 570828733 - ROPER HOSPITAL INC | NC | Family Medicine Physician (207Q00000X) |
United | 31652 | $848.94 | 1740280841 - THOMAS KAELIN | 300150674 - (SC) SUMMERVILLE SLEEP CONSULTANTS LLC | SC | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $2162.96 | 1548460744 - LESLIE WILKE | 570828733 - ROPER HOSPITAL INC | SC | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $1285.73 | 1558391326 - SUSAN TAYLOR | 626000101 - ERLANGER MEDICAL CENTER | MS | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $2114.78 | 1386621217 - MARCUM QUINN | 236291113 - GEISINGER CLINIC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $251.36 | 1851355614 - WILLIAM DAVIDSON | 520591531 - UPMC WESTERN MARYLAND CORPORATION | MD | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $2162.96 | 1275298945 - HEATHER FABEL | 570828733 - ROPER HOSPITAL INC | SC | Family Nurse Practitioner (363LF0000X) |
United | 31652 | $296.04 | 1407204233 - THOMAS WHITTON | 471216616 | KS | Pulmonary Disease Physician (207RP1001X) |
United | 31652 | $6651.00 | 1215307012 - BAY AREA SURGICENTER, LLC, BRANDON SURGERY CENTER | 474961128 - (FL) BAY AREA SURGICENTER LLC | 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 31652 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31652 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 31652 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 |
|---|---|---|
| 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) |
| 31652-CPT | High | Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed; With Endobronchial Ultrasound (Ebus) Guided Transtracheal And/Or Transbronchial Sampling (Eg Aspiration[S]/Biopsy[Ies]) One Or Two Mediastinal And/Or Hilar Lymph Node Stations Or Structures. |
| 31653-CPT | High | Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed; With Endobronchial Ultrasound (Ebus) Guided Transtracheal And/Or Transbronchial Sampling (Eg Aspiration[S]/Biopsy[Ies]) 3 Or More Mediastinal And/Or Hilar Lymph Node Stations Or Structures. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31652. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31652 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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