CPT 31654 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 • GC - Service performed by resident under supervision • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 31654 |
National average reimbursement for CPT 31654 by major payers:
$150.25
$174.92
$181.09
$212.87
| 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 31654 | ||||||
United | 31654 | $351.00 | 1558526293 - ENDOSCOPY CENTER OF THE ROCKIES LLC, ENDOSCOPY CENTER OF THE ROCKIES BOULDER | 841562782 - (CO) ENDOSCOPY CENTER OF THE ROCKIES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $574.00 | 1063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER | 371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $208.00 | 1295279586 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (NAPLES BASCOM PALMER - ASC) | 592579938 - UNIVERSITY OF MIAMI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $344.00 | 1720278047 - ARIZONA INSTITUTE OF EYE SURGERY LLC, PRESCOTT VISION & EYE SURGERY CENTER | 142002653 - (AZ) ARIZONA INSTITUTE OF EYE SURGERY, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $51.00 | 1770802555 - FAIRLAWN SURGERY CENTER, LLC | 271762713 - (VA) FAIRLAWN SURGERY CENTER, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $475.55 | 1275687873 - DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC | 610701663 - (KY) DERMATOLOGY ASSOCIATES OF KENTUCKY, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $172.00 | 1508845942 - ENDOSCOPY CENTER OF KNOXVILLE LP, THE ENDOSCOPY CENTER WEST | 621512837 - (TN) ENDOSCOPY CENTER OF KNOXVILLE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $85.00 | 1255872784 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $487.00 | 1588938682 - WEST SIDE GI, LLC | 271185812 - (NY) WESTSIDE GI CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $75.00 | 1376513440 - FLORIDA EYE CLINIC AMBULATORY SURGERY CENTER, INC. | 592303141 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $179.00 | 1700263415 - NORTH POINT SURGERY CENTER, LLC | 464488421 - (MO) NORTH POINT SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $172.00 | 1609537992 - NCH BONITA AMBULATORY SURGERY CENTER, LLC | 873854125 - (FL) NCH BONITA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $697.00 | 1508978990 - WOODBRIDGE CENTER LLC, ENDOSCOPY AND SURGERY CENTER AT WOODBRIDGE HILLS | 30553583 - (MI) WOODBRIDGE CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $79.00 | 1144216847 - RIVER PARK ASC LLC | 721510504 - (LA) RIVER PARK ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31654 | $1096.00 | 1922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP | 472388780 | CO | 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 31654 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31654 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 31654 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 |
|---|---|---|
| 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. |
| 31654-CPT | Low | Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed; With Transendoscopic Endobronchial Ultrasound (Ebus) During Bronchoscopic Diagnostic Or Therapeutic Intervention(S) For Periphera Lesion(S) (List Separately In Addition To Code For Primary Procedure[S]). |
| 31660-CPT | Moderate | Once Per Dos Bronchoscopy, Rigid Or Flexible, Including Fluoroscopic Guidance, When Performed -Deny Inv/N10>=1/1/2013 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31654. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31654 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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