CPT code 31614: Stoma revision, complex established-stoma revision2026 Medicare rate & RVUs in Texas
Reported for complex surgical reconstruction of an established tracheostoma, such as when significant scarring, narrowing, or deformity requires more than simple revision.
CMS doesn’t publish an office rate for 31614 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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What 31614 covers
An otolaryngologist or other airway surgeon revises an established tracheostoma when its shape, position, or surrounding tissue makes the opening difficult to maintain or use. Examples include substantial scar contracture or stomal narrowing. The operation may involve extensive release and reconstruction of the opening and surrounding tissues, typically in an operating-room setting. This is repair of an existing stoma, not creation of a new tracheostomy.
Select the complex revision rather than the simple revision based on the documented operative work and extent of reconstruction; the diagnosis alone does not establish complexity. The operative report should describe the stomal problem, tissue changes, and reconstructive steps. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery services are not paid, 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 31614 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 | $656.76 |
| Beaumont, TX | Unavailable | $610.55 |
| Brazoria, TX | Unavailable | $632.63 |
| Dallas, TX | Unavailable | $637.71 |
| Fort Worth, TX | Unavailable | $635.04 |
| Galveston, TX | Unavailable | $635.24 |
| Houston, TX | Unavailable | $657.75 |
| Rest of Texas | Unavailable | $621.98 |
How the 31614 rate is calculated
Each of 31614’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 · 31614
RVUs × geographic indexes × conversion factor
Work8.41
8.41 RVUs× 1.000 GPCI
Practice expense9.59
9.59 RVUs× 1.000 GPCI
Malpractice1.23
1.23 RVUs× 1.000 GPCI
Adjusted RVUs
19.2300
Conversion factor
$33.4009
Medicare rate
$642.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31614
31614 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31614
Stoma revision, complex established-stoma revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 31614
Stoma revision, complex established-stoma revision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
31614 without 51 · national facility
$642.30
Stoma revision, complex established-stoma revision
31614-51 · Second procedure: 50%
$321.15
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%).
31614 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31613Stoma revisionSimple revision
- Both revise an established tracheostoma. Choose 31614 for complex reconstruction and 31613 for simple revision, supported by the operative work.
- 31600TracheostomyPlanned, age two or older
- 31600 creates a planned tracheostomy; 31614 revises an opening that already exists.
- 31615Airway endoscopyThrough established tracheostomy
- 31615 describes tracheobronchoscopy through an established tracheostomy incision. It is an endoscopic examination, not surgical reconstruction of the stoma.
31614 billing questions
How do I distinguish this from 31613?
Use 31614 when the documented revision is complex and requires more extensive reconstruction; use 31613 for a simple revision. The operative report should support the level of work.
Is this used to create a new tracheostomy?
No. It revises an established tracheostoma. A procedure that creates a new tracheostomy is a different service, such as 31600 when appropriate.
Are related postoperative visits separately reported?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, Medicare pays the highest-valued procedure in full and other procedures at 50%.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing 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
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