CPT 40831 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 40831 |
National average reimbursement for CPT 40831 by major payers:

$369.20

$442.37

$443.48

$509.43
| 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 40831 | ||||||
United | 40831 | $83.00 | 1245215706 - SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION, THE FOOT SURGERY CENTER OF SHREVEPORT | 721198169 - (LA) SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $280.04 | 1770211179 - SAMANTHA SOLLMAN | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 40831 | $578.00 | 1063007573 - GEORGIA EYE SURGICENTER, LLC, GEORGIA EYE INSTITUTE SURGERY CENTER | 861925762 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $566.00 | 1114926714 - ENDOSCOPY CENTER OF DAYTON LTD | 311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $107.00 | 1952535502 - PLATEAU SURGERY CENTER | 264769256 - (TN) PLATEAU SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $366.00 | 1912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $553.00 | 1902851009 - 90210 SURGERY MEDICAL CENTER, LLC, 90210 SURGERY MEDICAL CENTER AT LINDEN | 134341801 - (CA) 90210 SURGERY MEDICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $566.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $703.00 | 1164870895 - SUMMIT ORTHOPEDICS LTD, EAGAN SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $450.00 | 1477695336 - SOMERSET OUTPATIENT SURGERY, LLC, RARITAN VALLEY SURGERY CENTER | 208433398 - (NJ) SOMERSET OUTPATIENT SURGERY, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $135.00 | 1790936847 - RSC SURGERY CENTER, LLC | 352345966 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $210.00 | 1154593481 - RANCHO MIRAGE SURGERY CENTER, LLC, RANCHO MIRAGE SURGERY CENTER | 262136928 - (CA) RANCHO MIRAGE SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $200.00 | 1093726796 - ROCKY MOUNTAIN EYE SURGERY CENTER INC | 810493712 - (MT) ROCKY MOUNTAIN EYE SURGERY CENTER INC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $550.00 | 1205899705 - EL PASO SURGERY CENTERS LP | 621846494 - (TX) EL PASO SURGERY CENTERS LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 40831 | $175.00 | 1407095359 - PAIN CARE CENTER OF GEORGIA LLC | 300523580 - (GA) PAIN CARE CENTER OF GEORGIA LLC | GA | 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 40831 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 40831 code is part of the Surgery services used for Surgical Procedures on the Digestive 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 40831 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 40831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 40831 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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