CPT code 31395: Airway reconstruction2026 Medicare rate & RVUs in Iowa
Reports major operative reconstruction involving the larynx and pharynx, typically to restore anatomy after a substantial head-and-neck defect.
CMS doesn’t publish an office rate for 31395 in Iowa.
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 31395 covers
This code represents major reconstruction of laryngeal and pharyngeal structures, rather than removal of a laryngeal lesion alone. An otolaryngologist or head-and-neck surgeon typically performs the operation in a hospital operating room, often when a substantial defect requires restoration of these connected structures. The operative report should make clear what anatomy was reconstructed and describe the reconstructive work performed.
Select the code based on the documented reconstruction, not simply because a laryngeal or pharyngeal resection occurred. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. 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.
31395 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | Unavailable | $2,350.36 |
How the 31395 rate is calculated
Each of 31395’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 · 31395
RVUs × geographic indexes × conversion factor
Work42.71
42.71 RVUs× 1.000 GPCI
Practice expense27.52
27.52 RVUs× 1.000 GPCI
Malpractice6.24
6.24 RVUs× 1.000 GPCI
Adjusted RVUs
76.4700
Conversion factor
$33.4009
Medicare rate
$2,554.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31395
31395 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31395
Airway reconstruction
| 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 · 31395
Airway reconstruction
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
31395 without 51 · national facility
$2,554.17
Airway reconstruction
31395-51 · Second procedure: 50%
$1,277.09
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%).
31395 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31300Laryngeal lesion removal
- 31300 concerns removal of a laryngeal lesion. Use 31395 only when the operative service includes reconstruction involving the larynx and pharynx.
- 31360Laryngectomy
- 31360 is a laryngeal removal procedure. This code instead represents reconstructive work involving both the larynx and pharynx.
- 31390Laryngopharyngectomy
- 31390 describes removal involving the larynx and pharynx. The distinguishing work for 31395 is reconstruction, not extirpation alone.
31395 billing questions
How does this differ from a laryngectomy code?
This code describes reconstructive work involving the larynx and pharynx. Laryngectomy codes describe removal of laryngeal structures; the operative report must support the reconstruction for this code.
Does removal of a lesion support this code?
Not by itself. A laryngeal lesion removal, such as the service represented by 31300, is different from reconstruction involving the larynx and pharynx.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures performed in that session.
What documentation supports reporting this code?
The operative report should identify the laryngeal and pharyngeal anatomy reconstructed and describe the reconstructive work. It should distinguish that work from resection alone.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is 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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