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CPT code 31603: Emergency tracheostomy, open tracheal airway2026 Medicare rate & RVUs

Reports an emergency surgical opening into the trachea to establish an airway when an urgent airway crisis requires tracheostomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities390 Medicare services in 2024

Medicare pays $278.56 for 31603 nationally in a facility.

Medicare rate · 31603

Emergency tracheostomy, open tracheal airway

Office or facility?

Work RVUs
5.85
Total RVUs
8.34
Global days
000

National rate · 2026

$278.56

Facility setting, before claim adjustments.

See every locality for 31603 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 31603 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 31603 covers

This service establishes an airway through a surgical opening in the trachea during an emergency. It is distinct from an emergency opening through the cricothyroid membrane. An ENT, trauma, or other qualified surgeon may perform it in a hospital emergency department or operating room when the patient needs an urgent surgical airway, such as when an airway cannot be secured by other means.

Report 31603 for the emergency tracheostomy performed, not for a planned tracheostomy or an emergency cricothyroidotomy. The operative record should support the emergency circumstances and identify the procedure performed and the airway site. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 31603 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

31603 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$257.02
AlaskaUnavailable$363.13
ArizonaUnavailable$271.91
ArkansasUnavailable$254.43
Atlanta, GAUnavailable$287.15
Austin, TXUnavailable$277.57
Bakersfield, CAUnavailable$272.69
Baltimore area, MDUnavailable$293.68
Beaumont, TXUnavailable$271.76
Brazoria, TXUnavailable$271.77

31603 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
31603 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 31603 rate is calculated

Each of 31603’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 31603

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.85

5.85 RVUs× 1.000 GPCI

Practice expense1.41

1.41 RVUs× 1.000 GPCI

Malpractice1.08

1.08 RVUs× 1.000 GPCI

Adjusted RVUs

8.3400

Conversion factor

$33.4009

Medicare rate

$278.56

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 31603

The CMS indicators that decide how 31603 is paid alongside other services.

CMS payment indicators · 31603

Emergency tracheostomy, open tracheal airway

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

31603 without 51 · national facility

$278.56

Emergency tracheostomy, open tracheal airway

31603-51 · Second procedure: 50%

$139.28

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

31603 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 31603

    Emergency tracheostomy, open tracheal airway5.85 wRVU

    Not priced

  • 31600

    Tracheostomy, planned, age two or older5.42 wRVU

    Not priced

  • 31601

    Tracheostomy, planned, under age two7.8 wRVU

    Not priced

  • 31605

    Emergency airway, transtracheal access6.29 wRVU

    Not priced

How to choose

31600TracheostomyPlanned, age two or older
31600 describes a planned tracheostomy. Choose 31603 when the tracheostomy is performed as an emergency.
31601TracheostomyPlanned, under age two
31601 is the planned tracheostomy code for a patient younger than two years; it is not the emergency procedure code.
31605Emergency airwayTranstracheal access
31605 creates an emergency airway through the cricothyroid membrane. 31603 creates the opening through the trachea.

Codes related to 31603

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 31603
CodeHow it relatesNational office range
Used instead
31600Tracheostomy, planned, age two or olderPlanned tracheostomy counterpart; use when the airway procedure is not an emergency.No office rate
31605Emergency airway, transtracheal accessEmergency surgical airway through the cricothyroid membrane rather than the trachea.No office rate
Same family
31601Tracheostomy, planned, under age twoPlanned tracheostomy code for a patient younger than two years.No office rate
31610Tracheostomy, skin-flap fenestrationTracheostomy involving fenestration of a skin flap, rather than an emergency airway.No office rate

31603 billing questions

How is 31603 different from 31605?

31603 is an emergency tracheostomy through the trachea. 31605 is an emergency airway procedure through the cricothyroid membrane.

Can 31603 be used for a planned tracheostomy?

No. Use the planned tracheostomy code that fits the service and patient; 31603 describes an emergency procedure.

Is modifier 50 appropriate for 31603?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the multiple-procedure rule affect 31603?

When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

Does the 0-day global include same-day follow-up care?

Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

Can an assistant or co-surgeon be billed for 31603?

CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 31603PPRRVU2026_Oct_nonQPP.csv, line 3,622 (RVU26D)

Open CMS sourceHow we calculate rates

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