No office rate
31600 describes a planned tracheostomy. Choose 31603 when the tracheostomy is performed as an emergency.
On this page
CMS RVU26D · Effective 2026-10-01
31603 Emergency tracheostomy Medicare reimbursement rates in Vermont
Reports an emergency surgical opening into the trachea to establish an airway when an urgent airway crisis requires tracheostomy. Compare 31603 office and facility rates across CMS payment localities in Vermont.
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 31603 in Vermont?
Vermont 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
$260.27
1 of 1 localities have a supported rate.
Payment area: Vermont
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 31603: Emergency transtracheal tracheostomy
Reports an emergency surgical opening into the trachea to establish an airway when an urgent airway crisis requires tracheostomy.
This service establishes an airway through a surgical opening in the trachea during an emergency. It is distinct from an emergency opening through the cricothyroid membrane. An ENT, trauma, or other qualified surgeon may perform it in a hospital emergency department or operating room when the patient needs an urgent surgical airway, such as when an airway cannot be secured by other means.
Report 31603 for the emergency tracheostomy performed, not for a planned tracheostomy or an emergency cricothyroidotomy. The operative record should support the emergency circumstances and identify the procedure performed and the airway site. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 31603
- 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 RVU5.85 · 70%
- Practice expense (office) RVU1.41 · 17%
- Malpractice RVU1.08 · 13%
390
Medicare services in 2024 · #3759 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.
31603 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
31601 is the planned tracheostomy code for a patient younger than two years; it is not the emergency procedure code.
No office rate
31605 creates an emergency airway through the cricothyroid membrane. 31603 creates the opening through the trachea.
Compare 31603 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
Vermont →
Office / nonfacility
Unavailable
Facility
$260.27
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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 31603 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,622
- Code
- 31603
- Physician work
- 5.85
- Practice expense
- 1.41
- Malpractice
- 1.08
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.85 | × 1.000 | 5.8500 |
| Practice expense | 1.41 | × 0.990 | 1.3959 |
| Malpractice | 1.08 | × 0.506 | 0.5465 |
| Total RVUs | 7.7924 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$260.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.85 | 1 |
| Practice expense | 1.41 | 0.99 |
| Malpractice | 1.08 | 0.506 |
(5.85 × 1 + 1.41 × 0.99 + 1.08 × 0.506) × $33.4009 = $260.27
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.
31603 billing questions
How is 31603 different from 31605?
31603 is an emergency tracheostomy through the trachea. 31605 is an emergency airway procedure through the cricothyroid membrane.
Can 31603 be used for a planned tracheostomy?
No. Use the planned tracheostomy code that fits the service and patient; 31603 describes an emergency procedure.
Is modifier 50 appropriate for 31603?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the multiple-procedure rule affect 31603?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Does the 0-day global include same-day follow-up care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can an assistant or co-surgeon be billed for 31603?
CMS does not pay an assistant at surgery for this code. 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.
3,61931599,,Unlisted procedure larynx,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817