No office rate
Both describe emergency surgical airways, but 31603 is the cervical approach and 31605 is transtracheal access through the cricothyroid region.
On this page
CMS RVU26D · Effective 2026-10-01
31605 Emergency airway Medicare reimbursement rates in Iowa
Reports emergency surgical airway access through the cricothyroid region when an acute obstruction requires transtracheal airway access. Compare 31605 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 31605 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$271.04
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Airway surgery
About 31605: Emergency transtracheal surgical airway
Reports emergency surgical airway access through the cricothyroid region when an acute obstruction requires transtracheal airway access.
This service creates emergency airway access through the cricothyroid membrane, commonly called a cricothyrotomy. It is used when a patient has an acute, critical airway problem and an airway cannot be secured by less invasive means. The procedure is typically performed by a physician in an emergency department, operating room, or other acute-care setting; the opening may provide temporary access for ventilation.
Report 31605 for the emergency transtracheal approach, not a planned tracheostomy or an emergency opening lower in the neck. Documentation should establish the airway emergency, the need for surgical access, and the transtracheal approach. CMS assigns 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 the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 31605
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.29 · 69%
- Practice expense (office) RVU1.40 · 15%
- Malpractice RVU1.37 · 15%
170
Medicare services in 2024 · #4474 by national volume
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.
31605 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
31600 is for a planned tracheostomy. Report 31605 when emergency transtracheal access is required.
No office rate
31500 reports emergency endotracheal intubation. 31605 reports surgical transtracheal access rather than placement of an endotracheal tube.
Compare 31605 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$271.04
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 31605 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,623
- Code
- 31605
- Physician work
- 6.29
- Practice expense
- 1.40
- Malpractice
- 1.37
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.29 | × 1.000 | 6.2900 |
| Practice expense | 1.40 | × 0.915 | 1.2810 |
| Malpractice | 1.37 | × 0.397 | 0.5439 |
| Total RVUs | 8.1149 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$271.04
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.29 | 1 |
| Practice expense | 1.4 | 0.915 |
| Malpractice | 1.37 | 0.397 |
(6.29 × 1 + 1.4 × 0.915 + 1.37 × 0.397) × $33.4009 = $271.04
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
31605 billing questions
How do I distinguish 31605 from 31603?
31605 is for emergency transtracheal access through the cricothyroid region. Use 31603 for an emergency cervical tracheostomy performed lower in the neck.
How does 31605 differ from a planned tracheostomy?
31605 describes emergency transtracheal airway access. A planned tracheostomy is reported with 31600, or 31601 for a patient younger than 2 years.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
Is an assistant at surgery payable?
No. CMS applies a statutory restriction on assistant-at-surgery payment for 31605. Co-surgeons and team surgery are also not permitted.
What same-session payment rule should I expect?
The highest-valued procedure is paid in full, with other procedures in the same session paid at 50%. The 0-day global period includes same-day preoperative and postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,62031600,,Planned tracheostomy,A,,5.42,1.69,NA,1.69,,1.07,8.18,8.18,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62131601,,Planned tracheostomy<2 yrs,A,,7.80,2.42,NA,2.42,,1.14,11.36,11.36,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62231603,,Emer tracheostomy ttrach,A,,5.85,1.41,NA,1.41,,1.08,8.34,8.34,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62331605,,Emer tracheostomy cthyr mem,A,,6.29,1.40,NA,1.40,,1.37,9.06,9.06,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,6243160F,,Doc fe+ stores b/4 epo thx,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62531610,,Tracheostomy fenest skin flp,A,,11.70,12.15,NA,12.15,,1.92,25.77,25.77,0,090,0.10,0.76,0.14,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62631611,,Constj trachesophgl fstl,A,,5.85,7.98,NA,7.98,,0.87,14.70,14.70,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136