Billing code 31612: Tracheal punctureMedicare rate & RVUs in Delaware

Report percutaneous tracheal puncture when a clinician accesses the trachea to aspirate airway secretions or deliver an injection through the puncture.

CMS RVU26DEffective Oct 1, 20261 payment locality120 Medicare services in 2024

Medicare pays $93.81 for 31612 in the office in Delaware (Delaware). Which amount applies depends on the service address.

$93.81Office (non-facility)
$41.34Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 31612 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What 31612 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 31612 covers

A clinician makes a percutaneous puncture into the trachea to aspirate secretions or deliver an injection. Pulmonary physicians and other clinicians performing airway procedures may use the technique to obtain lower-airway material for testing, particularly when a suitable sputum specimen is unavailable or difficult to obtain. It is distinct from collecting material through a bronchoscope and from creating a tracheostomy.

Report the service when the record supports a tracheal puncture and documents whether aspiration, injection, or both were performed, along with the clinical purpose and any specimen obtained. The code has 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 other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment requires documentation of medical necessity; 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.

31612 in Delaware

31612 office and facility rates by payment locality
Payment localityOfficeFacility
Delaware$93.81$41.34

How the 31612 rate is calculated

Each of 31612’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 · 31612

RVUs × geographic indexes × conversion factor

Work0.89

0.89 RVUs× 1.000 GPCI

Practice expense1.81

1.81 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

2.8400

Conversion factor

$33.4009

Medicare rate

$94.86

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 31612

The CMS indicators that decide how 31612 is paid alongside other services.

CMS payment indicators · 31612

Tracheal puncture

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)0Not paid without supporting documentation.
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

31612 without 51 · national office

$94.86

Tracheal puncture

31612-51 · Second procedure: 50%

$47.43

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

31612 compared with similar codes

Compare codes · National

4 codes, side by side

  • 31612

    Tracheal puncture0.89 wRVU

    $94.86

  • 31622

    Bronchoscopy2.47 wRVU

    $282.24+$187.38

  • 31624

    Bronchoscopy2.56 wRVU

    $286.25+$191.39

  • 31600

    Tracheostomy5.42 wRVU

    Not priced

How to choose

31622Bronchoscopy
Use 31612 for aspiration or injection through a percutaneous tracheal puncture. Use 31622 when airway inspection and washing are performed through a bronchoscope.
31624Bronchoscopy
31612 accesses the trachea percutaneously; 31624 obtains a lavage specimen bronchoscopically from the lower airways.
31600Tracheostomy
31600 creates a planned tracheostomy. 31612 is a tracheal puncture for aspiration or injection, not creation of a lasting airway opening.

31612 billing questions

How does this differ from bronchoscopy with washing or lavage?

This code describes access by percutaneous tracheal puncture for aspiration or injection. Bronchoscopic washing or lavage uses a bronchoscope to collect airway material.

What documentation supports reporting this code?

Document the percutaneous tracheal access, whether aspiration or injection was performed, the clinical purpose, and any specimen collected.

Is aspiration through an existing tracheostomy reported with this code?

No. This code is for percutaneous tracheal puncture, not routine suctioning through an existing tracheostomy tube.

Does this code have a global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. 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
RVUs for 31612PPRRVU2026_Oct_nonQPP.csv, line 3,627 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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