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See a sample rate comparisonCPT 31786 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.
Excis Tracheal Tumoror Carcinoma;Thorac
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | 22 - Increased Procedural Services 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | $1,360.75 national non-facility rate (2026) · View Medicare rates for 31786 |
| Medicaid Fee Schedule | $1,109.505 median of the 8 states in the free preview · View Medicaid rates for 31786 |
National average reimbursement for CPT 31786 by major payers:
$1,778.46
$1,951.76
$2,007.75
$2,361.87
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CPT 31786
5 of 25 sample ratesHigher to lower in this preview
Harrison Endo Surgical Center LLC
Harrison Endo Surgical Center, LLC
$4,300.00Published rateLongleaf Surgery Center, LLC
Longleaf Surgery Center LLC
$1,049.00Published rateSurgery Center Of Athens LLC
$807.00Published rateSurgicare Of Jackson Ltd
$610.00Published rateArrowhead Surgery Center LLC
$200.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 31786 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31786 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 31786 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 31786. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31786 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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