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Billing code 31605: Emergency airwayMedicare rate & RVUs

Reports emergency surgical airway access through the cricothyroid region when an acute obstruction requires transtracheal airway access.

CMS RVU26DEffective Oct 1, 2026109 payment localities170 Medicare services in 2024

Medicare pays $302.61 for 31605 nationally in a facility.

Medicare rate · 31605

Emergency airway

Swap in your local Medicare rate.

Work RVUs
6.29
Total RVUs
9.06
Global days
000

National rate · 2026

$302.61

Facility setting, before claim adjustments.

See every locality for 31605 → · 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 31605 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 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

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

109 of 109 payment localities

31605 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$276.91
Alaska*Unavailable$390.15
ArizonaUnavailable$294.57
ArkansasUnavailable$273.83
AtlantaUnavailable$313.19
AustinUnavailable$300.53
BakersfieldUnavailable$293.20
Baltimore/Surr. CntysUnavailable$320.23
BeaumontUnavailable$295.15
BrazoriaUnavailable$293.81

31605 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
31605 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 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

Swap in your local Medicare rate.

Work 6.29Practice expense 1.40Malpractice 1.37

9.0600 adjusted RVUs×$33.4009 conversion factor=$302.61

All indexes start 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

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

31605 without 51 · national facility

$302.61

Emergency airway

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%).

When to use modifier 51

31605 compared with similar codes

Compare codes

31605 vs 31603 vs 31600 vs 31500: national Medicare rates

Swap in your local Medicare rate.

  • 31605
    Emergency airway · 6.29 wRVU
    —
  • 31603
    Emergency tracheostomy · 5.85 wRVU
    —
  • 31600
    Tracheostomy · 5.42 wRVU
    —
  • 31500
    Emergency intubation · 2.93 wRVU
    —

How to choose

31603Emergency tracheostomy
Both describe emergency surgical airways, but 31603 is the cervical approach and 31605 is transtracheal access through the cricothyroid region.
31600Tracheostomy
31600 is for a planned tracheostomy. Report 31605 when emergency transtracheal access is required.
31500Emergency intubation
31500 reports emergency endotracheal intubation. 31605 reports surgical transtracheal access rather than placement of an endotracheal tube.

Codes related to 31605

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

Codes related to 31605
CodeHow it relatesNational office range
Same family
31603Emergency tracheostomyEmergency cervical tracheostomy; differs from 31605's transtracheal approach.No office rate
Used instead
31600TracheostomyPlanned tracheostomy for a nonemergency airway need.No office rate
31500Emergency intubationEmergency endotracheal intubation is a different airway-access method.No office rate

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

Show the CMS file lines behind this rate
RVUs for 31605PPRRVU2026_Oct_nonQPP.csv, line 3,623 (RVU26D)

Open CMS sourceHow we calculate rates

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