Billing code 31611: Voice fistulaMedicare rate & RVUs in Delaware
Creates a tracheoesophageal passage and places a voice prosthesis, typically for speech restoration after total laryngectomy.
CMS doesn’t publish an office rate for 31611 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 31611 covers
An otolaryngologist or head and neck surgeon creates a controlled opening between the trachea and esophagus and inserts a voice prosthesis. The passage lets exhaled air reach the pharyngoesophageal segment to support speech after removal of the larynx. The procedure may be done during the laryngectomy as a primary puncture or later as a secondary puncture in a patient with an established laryngectomy stoma.
Report the service when the operative work includes construction of the fistula and placement of the prosthesis; documentation should identify the procedure, the prosthesis, and whether the puncture is primary or secondary. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; 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.
31611 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $485.84 |
How the 31611 rate is calculated
Each of 31611’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 · 31611
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.85Practice expense 7.98Malpractice 0.87
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31611
31611 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31611
Voice fistula
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 31611
Voice fistula
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
31611 without 51 · national facility
$490.99
Voice fistula
31611-51 · Second procedure: 50%
$245.50
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%).
31611 compared with similar codes
Compare codes
31611 vs 31610 vs 31613 vs 31614 vs 31615: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31610Tracheostomy
- 31610 creates a tracheostomy with a skin flap; 31611 creates a tracheoesophageal passage and inserts a voice prosthesis.
- 31613Stoma revision
- 31613 revises a tracheostoma using a simple approach. It does not describe construction of a tracheoesophageal voice passage with prosthesis placement.
- 31614Stoma revision
- 31614 is for complex tracheostoma revision, rather than creating a tracheoesophageal fistula and placing a voice prosthesis.
- 31615Airway endoscopy
- 31615 describes endoscopic examination through an established tracheostomy. It is an airway examination, not voice-fistula construction.
31611 billing questions
How is this different from a tracheostomy?
This procedure creates a passage between the trachea and esophagus and places a voice prosthesis for speech after laryngectomy. A tracheostomy creates an airway opening through the neck.
Can it be performed during a total laryngectomy?
Yes. A primary tracheoesophageal puncture may be created during total laryngectomy; a secondary puncture is performed later through the established laryngectomy stoma.
Should modifier 50 be used for a bilateral procedure?
No. The anatomy and service described do not support a bilateral adjustment or modifier 50.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How does the multiple-procedure reduction affect this code?
When performed in the same session with other procedures, the highest-valued procedure is paid in full and the other procedures at 50%. The reduction depends on the relative values of the procedures in that session.
What documentation supports reporting the service?
The operative report should describe creation of the tracheoesophageal passage and insertion of the voice prosthesis, and indicate whether the puncture was primary or secondary.
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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