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Billing code 31786: Tracheal lesion excisionMedicare rate & RVUs

Reports surgical removal of a lesion in the intrathoracic trachea, rather than a cervical lesion or an endoscopic airway procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,360.75 for 31786 nationally in a facility.

Medicare rate · 31786

Tracheal lesion excision

Swap in your local Medicare rate.

Work RVUs
24.78
Total RVUs
40.74
Global days
090

National rate · 2026

$1,360.75

Facility setting, before claim adjustments.

See every locality for 31786 → · 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 31786 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 31786 covers

This code describes surgical removal of a tumor or other lesion from the portion of the trachea within the chest. A thoracic or airway surgeon typically performs the procedure in an operating room, with access selected for the lesion’s location and extent. The service is distinct from bronchoscopic sampling or endoscopic treatment of an airway lesion; the operative report should establish that the target was intrathoracic and surgically excised.

Choose this code over its cervical sibling based on the lesion’s anatomic location, and document the site, extent, approach, and work performed. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and 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 31786 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

31786 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,229.72
Alaska*Unavailable$1,702.11
ArizonaUnavailable$1,320.68
ArkansasUnavailable$1,213.89
AtlantaUnavailable$1,410.32
AustinUnavailable$1,357.48
BakersfieldUnavailable$1,326.15
Baltimore/Surr. CntysUnavailable$1,447.09
BeaumontUnavailable$1,316.74
BrazoriaUnavailable$1,318.60

31786 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
31786 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 31786 rate is calculated

Each of 31786’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 · 31786

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 24.78Practice expense 9.72Malpractice 6.24

40.7400 adjusted RVUs×$33.4009 conversion factor=$1,360.75

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

Payment rules and modifiers for 31786

31786 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 31786

Tracheal lesion excision

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 · 31786

Tracheal lesion excision

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

31786 without 51 · national facility

$1,360.75

Tracheal lesion excision

31786-51 · Second procedure: 50%

$680.38

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

31786 compared with similar codes

Compare codes

31786 vs 31785 vs 31781 vs 31641: national Medicare rates

Swap in your local Medicare rate.

  • 31786
    Tracheal lesion excision · 24.78 wRVU
    —
  • 31785
    Tracheal excision · 17.89 wRVU
    —
  • 31781
    Tracheal reconstruction · 24.23 wRVU
    —
  • 31641
    Therapeutic bronchoscopy · 4.89 wRVU
    —

How to choose

31785Tracheal excision
This code is for an intrathoracic tracheal lesion; 31785 is the cervical-location sibling. Base the choice on the documented operative site.
31781Tracheal reconstruction
31786 describes excision of an intrathoracic tracheal lesion. Use 31781 when the documented service is intrathoracic tracheal reconstruction.
31641Therapeutic bronchoscopy
31641 describes endoscopic treatment of an airway lesion. This code describes surgical excision of a lesion in the intrathoracic trachea.

Codes related to 31786

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

Codes related to 31786
CodeHow it relatesNational office range
Same family
31785Tracheal excisionSibling code for excision of a lesion in the cervical trachea.No office rate
Used instead
31781Tracheal reconstructionTracheal reconstruction may be reported when the service is reconstruction rather than lesion excision.No office rate
31760TracheoplastyIntrathoracic tracheoplasty describes repair or reconstruction rather than excision of a lesion.No office rate
31641Therapeutic bronchoscopyEndoscopic treatment of an airway lesion is distinct from surgical excision of an intrathoracic lesion.No office rate

31786 billing questions

How do I distinguish this code from 31785?

Use the lesion’s location: 31786 is for the intrathoracic trachea, while 31785 is for the cervical trachea. The operative documentation should make the location clear.

Can bronchoscopic biopsy or tumor treatment be reported instead?

A bronchoscopic service describes an endoscopic procedure, such as sampling or treating an airway lesion. This code describes surgical excision of an intrathoracic tracheal lesion.

What documentation supports reporting 31786?

Document the lesion’s location in the intrathoracic trachea, its extent, the surgical approach, and the excision performed. If additional airway reconstruction was done, describe that work separately in the operative report.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The code represents major surgery.

Can I append modifier 50 or report a surgical team?

Modifier 50 is inappropriate for this code. Team surgery is not permitted; an assistant at surgery may be paid, and co-surgeon payment requires supporting documentation.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 31786PPRRVU2026_Oct_nonQPP.csv, line 3,676 (RVU26D)

Open CMS sourceHow we calculate rates

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