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Billing code 31395: Airway reconstructionMedicare rate & RVUs

Reports major operative reconstruction involving the larynx and pharynx, typically to restore anatomy after a substantial head-and-neck defect.

CMS RVU26DEffective Oct 1, 2026109 payment localities29 Medicare services in 2024

Medicare pays $2,554.17 for 31395 nationally in a facility.

Medicare rate · 31395

Airway reconstruction

Swap in your local Medicare rate.

Work RVUs
42.71
Total RVUs
76.47
Global days
090

National rate · 2026

$2,554.17

Facility setting, before claim adjustments.

See every locality for 31395 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 31395 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 31395 covers

This code represents major reconstruction of laryngeal and pharyngeal structures, rather than removal of a laryngeal lesion alone. An otolaryngologist or head-and-neck surgeon typically performs the operation in a hospital operating room, often when a substantial defect requires restoration of these connected structures. The operative report should make clear what anatomy was reconstructed and describe the reconstructive work performed.

Select the code based on the documented reconstruction, not simply because a laryngeal or pharyngeal resection occurred. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Team surgery is 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 31395 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

31395 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,348.81
Alaska*Unavailable$3,233.61
ArizonaUnavailable$2,495.66
ArkansasUnavailable$2,323.48
AtlantaUnavailable$2,615.05
AustinUnavailable$2,586.57
BakersfieldUnavailable$2,588.02
Baltimore/Surr. CntysUnavailable$2,693.49
BeaumontUnavailable$2,456.64
BrazoriaUnavailable$2,511.45

31395 rates by state

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

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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
31395 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 31395 rate is calculated

Each of 31395’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 · 31395

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 42.71Practice expense 27.52Malpractice 6.24

76.4700 adjusted RVUs×$33.4009 conversion factor=$2,554.17

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 31395

31395 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 31395

Airway reconstruction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.76/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 31395

Airway reconstruction

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

31395 without 51 · national facility

$2,554.17

Airway reconstruction

31395-51 · Second procedure: 50%

$1,277.09

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

31395 compared with similar codes

Compare codes

31395 vs 31300 vs 31360 vs 31390: national Medicare rates

Swap in your local Medicare rate.

  • 31395
    Airway reconstruction · 42.71 wRVU
    —
  • 31300
    Laryngeal lesion removal · 15.51 wRVU
    —
  • 31360
    Laryngectomy · 29.16 wRVU
    —
  • 31390
    Laryngopharyngectomy · 41.45 wRVU
    —

How to choose

31300Laryngeal lesion removal
31300 concerns removal of a laryngeal lesion. Use 31395 only when the operative service includes reconstruction involving the larynx and pharynx.
31360Laryngectomy
31360 is a laryngeal removal procedure. This code instead represents reconstructive work involving both the larynx and pharynx.
31390Laryngopharyngectomy
31390 describes removal involving the larynx and pharynx. The distinguishing work for 31395 is reconstruction, not extirpation alone.

Codes related to 31395

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

Codes related to 31395
CodeHow it relatesNational office range
Used instead
31300Laryngeal lesion removalRepresents removal of a laryngeal lesion, rather than laryngeal and pharyngeal reconstruction.No office rate
Same family
31360LaryngectomyA laryngeal removal procedure; distinguish extirpation from the reconstruction reported here.No office rate
31390LaryngopharyngectomyRepresents removal involving the larynx and pharynx, not reconstruction of those structures.No office rate

31395 billing questions

How does this differ from a laryngectomy code?

This code describes reconstructive work involving the larynx and pharynx. Laryngectomy codes describe removal of laryngeal structures; the operative report must support the reconstruction for this code.

Does removal of a lesion support this code?

Not by itself. A laryngeal lesion removal, such as the service represented by 31300, is different from reconstruction involving the larynx and pharynx.

Should modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures performed in that session.

What documentation supports reporting this code?

The operative report should identify the laryngeal and pharyngeal anatomy reconstructed and describe the reconstructive work. It should distinguish that work from resection alone.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is 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 31395PPRRVU2026_Oct_nonQPP.csv, line 3,567 (RVU26D)

Open CMS sourceHow we calculate rates

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