CPT 31785 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 31785 |
National average reimbursement for CPT 31785 by major payers:

$1,346.77

$1,431.96

$1,502.63

$1,788.30
| 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 31785 | ||||||
United | 31785 | $799.00 | 1437482924 - FORT MYERS EYE SURGERY CENTER LLC | 262301308 - (FL) FORT MYERS EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $3400.00 | 1659810703 - MILWAUKEE SURGICAL SUITES, LLC | 814264488 - (WI) MILWAUKEE SURGICAL SUITES, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $1129.00 | 1093276859 - JACKSONVILLE OUTPATIENT SURGERY CENTER, LLC | 833910772 - (FL) JACKSONVILLE OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $1153.00 | 1528369972 - INSIGHT GROUP, LLC | 261871061 - (LA) INSIGHT GROUP LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $1230.00 | 1619487782 - UCH VASCULAR ACCESS ASC LLC | 820975009 - (TN) UCH VASCULAR ACCESS ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $859.00 | 1992186852 - NORTHWAY SPC LLC | 464378533 - (NY) NORTHWAY SPC, LLC D/B/A NORTHWAY SURGERY AND PAIN CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $4416.00 | 1750892659 - NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC | 821651821 - (NC) NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $3427.00 | 1497749667 - CALIFORNIA SPECIALTY SURGERY CENTER, LLC, CALIFORNIA SPECIALTY SURGERY CENTER, LLC | 330939003 - (CA) CALIFORNIA SPECIALTY SURGERY CENTER, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $2709.00 | 1730698374 - ADVANCED SURGICAL CENTER OF SUNSET HILLS LLC | 821806934 - (MO) ADVANCED SURGICAL CENTER OF SUNSET HILLS, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $1272.00 | 1619244175 - BARRINGTON PAIN AND SPINE INSTITUTE, LLC, BARRINGTON AMBULATORY SURGERY CENTER | 273091392 - (IL) BARRINGTON PAIN AND SPINE INSTITUTE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $2060.00 | 1336209451 - SADDLE RIVER VALLEY SURGICAL CENTER LLC, SADDLE RIVER VALLEY SURGICAL CENTER LLC | 201250583 - (NJ) SADDLE RIVER VALLEY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $1236.00 | 1306476197 - EAMC-LANIER AMBULATORY SURGERY CENTER, LLC | 843468862 - (AL) EAMCLANIER AMBULATORY SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $2300.00 | 1831551266 - INOV8 SURGICAL AT MEMORIAL CITY, INOV8 SURGICAL | 475640889 - (TX) INOV8 SURGICAL AT MEMORIAL CITY | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $1418.00 | 1134157225 - OCEAN SPRINGS SURGICAL AND ENDOSCOPY CENTER LLC, OCEAN SPRINGS SURGICAL AND ENDOSCOPY CENTER | 640922411 - (MS) OCEAN SPRINGS SURGICAL & ENDOSCOPY CENTER | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 31785 | $542.00 | 1114177417 - NISENFELD & CHILTON, MD PA, ORTHOPAEDIC ASSOCIATES OF FREDERICK, ASC | 521135399 - (MD) NISENFELD & CHILTON, M.D., P.A. | MD | 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 31785 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31785 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 31785 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31785 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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