CPT code 31605: Emergency airway, transtracheal access2026 Medicare rate & RVUs in Texas
Reports emergency surgical airway access through the cricothyroid region when an acute obstruction requires transtracheal airway access.
CMS doesn’t publish an office rate for 31605 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 31605 covers
This service creates emergency airway access through the cricothyroid membrane, commonly called a cricothyrotomy. It is used when a patient has an acute, critical airway problem and an airway cannot be secured by less invasive means. The procedure is typically performed by a physician in an emergency department, operating room, or other acute-care setting; the opening may provide temporary access for ventilation.
Report 31605 for the emergency transtracheal approach, not a planned tracheostomy or an emergency opening lower in the neck. Documentation should establish the airway emergency, the need for surgical access, and the transtracheal approach. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery 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 31605 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $300.53 |
| Beaumont, TX | Unavailable | $295.15 |
| Brazoria, TX | Unavailable | $293.81 |
| Dallas, TX | Unavailable | $297.82 |
| Fort Worth, TX | Unavailable | $297.95 |
| Galveston, TX | Unavailable | $296.09 |
| Houston, TX | Unavailable | $321.17 |
| Rest of Texas | Unavailable | $295.79 |
How the 31605 rate is calculated
Each of 31605’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 · 31605
RVUs × geographic indexes × conversion factor
Work6.29
6.29 RVUs× 1.000 GPCI
Practice expense1.40
1.40 RVUs× 1.000 GPCI
Malpractice1.37
1.37 RVUs× 1.000 GPCI
Adjusted RVUs
9.0600
Conversion factor
$33.4009
Medicare rate
$302.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31605
The CMS indicators that decide how 31605 is paid alongside other services.
CMS payment indicators · 31605
Emergency airway, transtracheal access
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
31605 without 51 · national facility
$302.61
Emergency airway, transtracheal access
31605-51 · Second procedure: 50%
$151.31
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%).
31605 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31603Emergency tracheostomyOpen tracheal airway
- Both describe emergency surgical airways, but 31603 is the cervical approach and 31605 is transtracheal access through the cricothyroid region.
- 31600TracheostomyPlanned, age two or older
- 31600 is for a planned tracheostomy. Report 31605 when emergency transtracheal access is required.
- 31500Emergency intubationEmergency airway placement
- 31500 reports emergency endotracheal intubation. 31605 reports surgical transtracheal access rather than placement of an endotracheal tube.
31605 billing questions
How do I distinguish 31605 from 31603?
31605 is for emergency transtracheal access through the cricothyroid region. Use 31603 for an emergency cervical tracheostomy performed lower in the neck.
How does 31605 differ from a planned tracheostomy?
31605 describes emergency transtracheal airway access. A planned tracheostomy is reported with 31600, or 31601 for a patient younger than 2 years.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
Is an assistant at surgery payable?
No. CMS applies a statutory restriction on assistant-at-surgery payment for 31605. Co-surgeons and team surgery are also not permitted.
What same-session payment rule should I expect?
The highest-valued procedure is paid in full, with other procedures in the same session paid at 50%. The 0-day global period includes same-day preoperative and postoperative care.
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
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