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CPT 31820 Fee Schedule

Last Verified: December 2025

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.

Surg.Cl.Trachestmy/Fist;W/O Pl.Repr
Key FactDetail
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

AG - Primary physician

51 - Multiple procedures

Complexity LevelModerate

National average reimbursement for CPT 31820 by major payers:

bcbs

$508.45

uhc

$564.74

aetna

$617.87

cigna

$723.65

Preview provider-level rates for...
For billing codeCPT 31820
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 31820

United
31820$3993.001235797630 - AUSTIN GI SURGICENTER, LLC, AUSTIN ENDOSCOPY CENTER301073754 - (TX) AUSTIN GI SURGICENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1400.001326402884 - ORTHOPAEDIC INSTITUTE FOR CHILDREN AMBULATORY SURGERY CENTER, LLC812159060 - (CA) ORTHOPAEDIC INSTITUTE FOR CHILDREN AMBULATORY SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$2206.001437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIELAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1300.001740876671 - FRESENIUS VASCULAR CARE DAYTON ASC LLC852997056 - (OH) FRESENIUS VASCULAR CARE DAYTON ASC LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1050.001033560420 - ABINGDON SURGICAL CENTER PC813054896 - (MD) ABINGDON SURGICAL CENTER PCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1564.001275376121 - CLEARWAY SURGERY CENTER OF NATIONAL HARBOR LLC454110190 - (MD) HARBORSIDE SURGERY CENTERMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$4902.001720543481 - SURGICAL SUITES OF COASTAL VIRGINIA, LLC833205375 - (VA) SURGICAL SUITES OF COASTAL VIRGINIA LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$8705.001205939345 - BELTWAY SURGERY CENTERS LLC, INDIANA HAND TO SHOULDER BELTWAY SURGERY CENTER352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1037.001093779951 - EYE SURGERY AND LASER CLINIC, INC.562172461 - (NC) EYE SURGERY AND LASER CLINIC INCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1401.001689748758 - PARK AVENUE SURGERY CENTER LLC721565454 - (CO) PARK AVENUE SURGERY CENTER, LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1734.001720606932 - PHYSICIANS CLINIC INC470687317 - PHYSICIANS CLINIC INCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$2859.001316947609 - AMARILLO ENDOSCOPY CENTER, LP752893120 - (TX) AMARILLO ENDOSCOPY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1400.001649893934 - SIMI VALLEY SURGERY CENTER INC841997544 - (CA) SIMI VALLEY SURGERY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$3344.001811973639 - SUMMIT ORTHOPEDICS LTD, DBA LANDMARK SURGERY CENTER411762331 - SUMMIT ORTHOPEDICS, LTD.MNAmbulatory Surgical Clinic/Center (261QA1903X)
United
31820$1180.001518450790 - VIRGINIA ENT SURGERY CENTER INC825301397 - (VA) VIRGINIA ENT SURGERY CENTER INCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 31820 vs. Other Surgical Procedures on the Respiratory System Codes

The CPT 31820 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 31820 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.

CodeComplexityDescription
31800-CPTModerateSuture Ext.Tracheal Wound/Inj;Cerv
31805-CPTHighSuture Ext Trach Wound Intrathorac
31820-CPTModerateSurg.Cl.Trachestmy/Fist;W/O Pl.Repr
31825-CPTModerateClosure Tracheos/Fistula Plast Rep

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 31820 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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