Billing code 31612: Tracheal punctureMedicare rate & RVUs in Texas
Report percutaneous tracheal puncture when a clinician accesses the trachea to aspirate airway secretions or deliver an injection through the puncture.
Medicare pays $89.09–$97.89 for 31612 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 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.
Where 31612 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$89.09 to $97.89
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $97.89 | $41.70 |
| Beaumont | $89.09 | $40.76 |
| Brazoria | $93.52 | $40.89 |
| Dallas | $94.22 | $41.33 |
| Fort Worth | $93.68 | $41.31 |
| Galveston | $93.87 | $41.13 |
| Houston | $96.43 | $43.70 |
| Rest Of Texas | $91.32 | $40.92 |
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
Swap in your local Medicare rate.
Work 0.89Practice expense 1.81Malpractice 0.14
All indexes start 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
31612 compared with similar codes
Compare codes
31612 vs 31622 vs 31624 vs 31600: national Medicare rates
Swap in your local Medicare rate.
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
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