Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 31805 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.
Suture Ext Trach Wound Intrathorac
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | 78 - Return to OR - related procedure 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | $794.94 national non-facility rate (2026) · View Medicare rates for 31805 |
| Medicaid Fee Schedule | $623.61 median of the 8 states in the free preview · View Medicaid rates for 31805 |
National average reimbursement for CPT 31805 by major payers:
$1,046.04
$1,097.35
$1,129.04
$1,344.19
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 31805.
CPT 31805
5 of 25 sample ratesHigher to lower in this preview
Ball Outpatient Surgery Center, LLC, Ball Outpatient Surgery Center
Ball Outpatient Surgery Center LLC
$4,343.00Published rateSurgcenter Of Greater Phoenix, LLC
Surgcenter Of Greater Phoenix LLC
$1,073.00Published rateWest Las Vegas Surgery Center,LLC, Valley View Surgery Center
West Las Vegas Surgery Center LLC D/B/A Valley View Surgery Center
$721.00Published rateBarnet Dulaney Perkins Eye Center, PC, American Vision Partners
Barnet Dulaney Perkins Eye Center PLLC
$492.00Published rateNorthern Arizona Eye Associates
$100.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 31805 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31805 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 31805 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 |
|---|---|---|
| 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. |
| 31780-CPT | High | Excis Tracheal Stenosis/Anast;Cerv |
| 31786-CPT | High | Excis Tracheal Tumoror Carcinoma;Thorac |
| 31805-CPT | High | Suture Ext Trach Wound Intrathorac |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31805. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31805 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 31805) and we'll show you how you compare in 15 minutes or less.