Billing code 31603: Emergency tracheostomyMedicare rate & RVUs in Delaware
Reports an emergency surgical opening into the trachea to establish an airway when an urgent airway crisis requires tracheostomy.
CMS doesn’t publish an office rate for 31603 in Delaware.
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 9 sections
What 31603 covers
This service establishes an airway through a surgical opening in the trachea during an emergency. It is distinct from an emergency opening through the cricothyroid membrane. An ENT, trauma, or other qualified surgeon may perform it in a hospital emergency department or operating room when the patient needs an urgent surgical airway, such as when an airway cannot be secured by other means.
Report 31603 for the emergency tracheostomy performed, not for a planned tracheostomy or an emergency cricothyroidotomy. The operative record should support the emergency circumstances and identify the procedure performed and the airway site. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, 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.
31603 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $275.33 |
How the 31603 rate is calculated
Each of 31603’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 · 31603
RVUs × geographic indexes × conversion factor
Work5.85
5.85 RVUs× 1.000 GPCI
Practice expense1.41
1.41 RVUs× 1.000 GPCI
Malpractice1.08
1.08 RVUs× 1.000 GPCI
Adjusted RVUs
8.3400
Conversion factor
$33.4009
Medicare rate
$278.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31603
The CMS indicators that decide how 31603 is paid alongside other services.
CMS payment indicators · 31603
Emergency tracheostomy
| 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
31603 without 51 · national facility
$278.56
Emergency tracheostomy
31603-51 · Second procedure: 50%
$139.28
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%).
31603 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31600Tracheostomy
- 31600 describes a planned tracheostomy. Choose 31603 when the tracheostomy is performed as an emergency.
- 31601Tracheostomy
- 31601 is the planned tracheostomy code for a patient younger than two years; it is not the emergency procedure code.
- 31605Emergency airway
- 31605 creates an emergency airway through the cricothyroid membrane. 31603 creates the opening through the trachea.
31603 billing questions
How is 31603 different from 31605?
31603 is an emergency tracheostomy through the trachea. 31605 is an emergency airway procedure through the cricothyroid membrane.
Can 31603 be used for a planned tracheostomy?
No. Use the planned tracheostomy code that fits the service and patient; 31603 describes an emergency procedure.
Is modifier 50 appropriate for 31603?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the multiple-procedure rule affect 31603?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Does the 0-day global include same-day follow-up care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can an assistant or co-surgeon be billed for 31603?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery 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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