No office rate
Both codes revise an established tracheostoma. Select 31613 for simple revision and 31614 when the documented reconstruction is complex.
On this page
CMS RVU26D · Effective 2026-10-01
31613 Stoma revision Medicare reimbursement rates in Maine
Revision of a narrowed or poorly shaped tracheostomy opening to improve its form or function, when the operative work is simple rather than complex. Compare 31613 office and facility rates across CMS payment localities in Maine.
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 31613 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$369.24–$384.93
2 of 2 localities have a supported rate.
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 31613: Simple tracheostoma revision
Revision of a narrowed or poorly shaped tracheostomy opening to improve its form or function, when the operative work is simple rather than complex.
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.
CMS billing rules for 31613
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 RVU4.59 · 39%
- Practice expense (office) RVU6.52 · 55%
- Malpractice RVU0.75 · 6%
421
Medicare services in 2024 · #3690 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.
31613 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
31600 creates a planned tracheostomy; 31613 revises an existing tracheostoma.
$161.47–$168.99
31615 describes endoscopic examination through an established tracheostomy, not surgical reshaping of the stoma.
Compare 31613 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$369.24
Southern Maine →
Office / nonfacility
Unavailable
Facility
$384.93
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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 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.
3,62531610,,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
3,62731612,,Perq trchl pnxr ttrach aspir,A,,0.89,1.81,,0.22,,0.14,2.84,1.25,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62831613,,Tracheostoma revj simple,A,,4.59,6.52,NA,6.52,,0.75,11.86,11.86,0,090,0.10,0.76,0.14,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62931614,,Tracheostoma revj complex,A,,8.41,9.59,NA,9.59,,1.23,19.23,19.23,0,090,0.10,0.76,0.14,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,63031615,,Trcheobrnchsc est trachs inc,A,,1.79,3.14,,1.01,,0.25,5.18,3.05,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,63131622,,Dx bronchoscope/wash,A,,2.47,5.68,,0.83,,0.30,8.45,3.60,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00