CPT 34831 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 Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None GC - Service performed by resident under supervision 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 34831 |
| Medicaid Fee Schedule | View Medicaid rates for 34831 |
National average reimbursement for CPT 34831 by major payers:
$2,575.47
$2,688.09
$2,717.42
$3,068.99
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 34831 | $1000.00 | 1700546629 - STONE OAK SURGICENTER, LLC | 873925488 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $315.00 | 1720081664 - HEATON LASER AND SURGERY CENTER L L C | 752752100 - (TX) HEATON LASER AND SURGERY CENTER L L C | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $320.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $550.00 | 1598815110 - EXECUTIVE ENDOSCOPY, INC., ENDOSCOPY CENTER OF SAN JOSE | 770583401 - (CA) EXECUTIVE ENDOSCOPY INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $1234.00 | 1912090432 - MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE, LLC | 812557673 - (DC) MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE LLC | DC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $248.00 | 1063040731 - POWDER RIVER SURGERY CENTER | 845166436 | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $525.00 | 1528206141 - HATTIESBURG EYE CLINIC CATARACT & LASIK SURGERY CENTER, LLC | 200379151 - (MS) HATTIESBURG EYE CLINIC CATARACT LASIK SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $110.00 | 1720125156 - SCOTTSDALE EYE INSTITUTE, PLC, SCOTTSDALE EYE INSTITUTE, PLC | 61692976 - (AZ) SCOTTSDALE EYE INSTITUTE PLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $129.00 | 1720099260 - MEAH ASC MANAGEMENT, LLC | 760663270 - (TX) MEAH ASC MANAGEMENT LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $600.00 | 1144291923 - INTERVENTIONAL THERAPEUTICS INSTITUTE, LLC, CLEARWAY SURGERY CENTER | 830432335 - (FL) INTERVENTIONAL THERAPEUTICS INSTITUTE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $775.00 | 1750694832 - SURGICARE ASSOCIATES, LLC | 272802420 - (PA) SURGICARE ASSOCIATES LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $1954.00 | 1558050831 - BAPTIST HEALTH SURGERY CENTER, LLC | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $1167.00 | 1831180272 - ADVANCED ENDOSCOPY CENTER LLC | 861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $640.00 | 1831637875 - UCSC LLC, UNION CITY SURGERY CENTER | 814012677 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 34831 | $624.00 | 1194047092 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | 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 34831 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 34831 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular 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 34831 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 |
|---|---|---|
| 34830-CPT | High | Revision Of Artery Repair, Surgery To Revise An Initial Failed Attempt To Stabilize A Bulge (Aneurysm) Or Repair A Segment Of The Largest Artery (Aorta). The Procedure Inserts A Support Device (Stent). |
| 34831-CPT | High | Revision Of Artery Repair, Surgery To Revise An Initial Failed Attempt To Stabilize A Bulge (Aneurysm) Or Repair A Segment Of The Largest Artery (Aorta). The Procedure Inserts A Support Device (Stent). |
| 34832-CPT | High | Revision Of Artery Repair, Surgery To Revise An Initial Failed Attempt To Stabilize A Bulge (Aneurysm) Or Repair A Segment Of The Largest Artery (Aorta). The Procedure Inserts A Support Device (Stent). |
| 34845-CPT | High | Visc Infraren Abd 1 Prosth, Endovascular Repair Of Visceral Aorta And Infrarenal Abdominal Aorta Eg Aneurysm Pseudoaneurysm Dissection Penetrating Ulcer Intramural Hematoma Or Traumatic Disruption With A Fenestrated Visceral Aortic Endograft And Concomitant Unibody Or Modular Infrarenal Aortic Endograft And All Associated Radiological Supervision And Interpretation Including Target Zone Angioplasty When Performed Including One Visceral Artery Endoprosthesis Superior Mesenteric Celiac Or Renal Artery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 34831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 34831 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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