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See a sample rate comparisonCPT 31766 Fee Schedule
Last Verified: October 2026
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.
Surgery To Rebuild Airway, Surgery To Reconstruct The Airway Opening To The Lungs. The Procedure Can Involve Enlarging The Passages Grafting Tissue Or Removing Scar Tissue.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | 51 - Multiple procedures 22 - Increased Procedural Services 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | $1,668.71 national non-facility rate (2026) · View Medicare rates for 31766 |
| Medicaid Fee Schedule | $1,301.37 median of the 8 states in the free preview · View Medicaid rates for 31766 |
National average reimbursement for CPT 31766 by major payers:
$2,233.23
$2,390.21
$2,460.99
$2,887.43
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CPT 31766
5 of 25 sample ratesHigher to lower in this preview
Surgical Suites Of Coastal Virginia, LLC
Surgical Suites Of Coastal Virginia LLC
$2,013.00Published rateAdvanced Surgery Center Of Northern Louisiana LLC
Advanced Surgery Center Of Northern Louisiana, LLC
$1,028.00Published rateCenter For Urologic Surgery LLC
$744.00Published rateMagnolia Surgery Center, LLC
Magnolia Surgery Center LLC
$443.00Published rateNorth Valley Endoscopy Center LLC
$109.00Published rate
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See a sample payer proposalCPT 31766 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31766 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 31766 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 |
|---|---|---|
| 31755-CPT | High | Surgery To Rebuild Windpipe, Surgery To Reconstruct The Windpipe (Trachea). The Procedure May Involve Creating An Opening Between The Throat And Nose. Cartilage Grafts May Be Used. |
| 31760-CPT | High | Surgery To Rebuild Windpipe, Surgery To Reconstruct The Windpipe (Trachea). The Procedure May Involve Creating An Opening Between The Throat And Nose. Cartilage Grafts May Be Used. |
| 31766-CPT | High | Surgery To Rebuild Airway, Surgery To Reconstruct The Airway Opening To The Lungs. The Procedure Can Involve Enlarging The Passages Grafting Tissue Or Removing Scar Tissue. |
| 31770-CPT | High | Surgery To Rebuild Airway, Surgery To Reconstruct The Airway Opening To The Lungs. The Procedure Can Involve Enlarging The Passages Grafting Tissue Or Removing Scar Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31766. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31766 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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