Billing code 31613: Stoma revisionMedicare rate & RVUs in Guam
Revision of a narrowed or poorly shaped tracheostomy opening to improve its form or function, when the operative work is simple rather than complex.
CMS doesn’t publish an office rate for 31613 in Guam.
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 31613 covers
An otolaryngologist or other surgeon revises an established tracheostoma when scar, narrowing, or deformity interferes with the opening’s function or the fit of a tracheostomy tube. The work reshapes the stoma, often using nearby tissue, rather than creating a new tracheostomy. It is performed in a surgical setting and is distinct from endoscopic inspection of the airway through an existing stoma.
Choose this code when the operative report supports a simple revision; use the complex revision code when the reconstruction is more extensive. Document the stoma’s problem, the revision performed, and the extent of tissue work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery services are not paid under the statutory restriction; 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.
31613 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $415.42 |
How the 31613 rate is calculated
Each of 31613’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 · 31613
RVUs × geographic indexes × conversion factor
Work4.59
4.59 RVUs× 1.000 GPCI
Practice expense6.52
6.52 RVUs× 1.000 GPCI
Malpractice0.75
0.75 RVUs× 1.000 GPCI
Adjusted RVUs
11.8600
Conversion factor
$33.4009
Medicare rate
$396.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31613
31613 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31613
Stoma revision
| 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) | 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. |
| 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 · 31613
Stoma revision
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
31613 without 51 · national facility
$396.13
Stoma revision
31613-51 · Second procedure: 50%
$198.07
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%).
31613 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31614Stoma revision
- Both codes revise an established tracheostoma. Select 31613 for simple revision and 31614 when the documented reconstruction is complex.
- 31600Tracheostomy
- 31600 creates a planned tracheostomy; 31613 revises an existing tracheostoma.
- 31615Airway endoscopy
- 31615 describes endoscopic examination through an established tracheostomy, not surgical reshaping of the stoma.
31613 billing questions
How do I choose between this code and 31614?
Use 31613 for a simple revision of an existing tracheostoma. Use 31614 when the operative report documents a complex reconstruction.
Is this code for creating a new tracheostomy?
No. It describes revision of an established stoma; planned creation of a tracheostomy is reported with a creation code such as 31600.
What documentation supports the simple revision?
Document the existing stoma’s narrowing, scar, or deformity, its functional effect, and the specific revision and tissue work performed. The operative detail should support the simple rather than complex level.
Can modifier 50 be reported?
No. The descriptor and anatomy do not support bilateral reporting with modifier 50.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code under the statutory restriction. 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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