CPT 31231

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County)

$229 in an office; $58.70 in a hospital or surgery center

Doctor's fee, rest of Washington

$201 in an office; $54.69 in a hospital or surgery center

Hospital outpatient payment (national)

$204 (APC 5151)

Surgery center payment (national)

$110

How hospitals also write this code

Some price files write it differently. These are counted as CPT 31231:

• 31231P (with a letter after it, P; 2 price lines)
• 31231T (with a letter after it, T; 1 price line)