CPT code 31825: Tracheal defect repair2026 Medicare rate & RVUs in Washington
Surgical closure of a persistent tracheostomy-site fistula when the repair includes plastic reconstruction of the surrounding tissue.
Medicare pays $623.93–$694.60 for 31825 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 31825 covers
This service closes a persistent opening between the trachea and skin after a tracheostomy, using plastic repair rather than simple closure alone. It is typically performed by an otolaryngologist or a thoracic surgeon in an operating room for a patient whose tracheostomy has been removed but whose tracheocutaneous fistula remains. The operative report should establish that the service addressed the fistula and included plastic repair.
Report this code instead of the simple-closure code when the documented repair includes plastic reconstruction. Medicare treats it as major surgery with 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 50% reduction. Modifier 50 is inappropriate for this repair. An assistant at surgery is paid only when medical necessity is documented; 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 31825 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $623.93 | $433.66 |
| Seattle (King Cnty) | $694.60 | $472.88 |
How the 31825 rate is calculated
Each of 31825’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 · 31825
RVUs × geographic indexes × conversion factor
Work6.89
6.89 RVUs× 1.000 GPCI
Practice expense10.36
10.36 RVUs× 1.000 GPCI
Malpractice1.04
1.04 RVUs× 1.000 GPCI
Adjusted RVUs
18.2900
Conversion factor
$33.4009
Medicare rate
$610.90
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31825
31825 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31825
Tracheal defect repair
| 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) | 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. |
| 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 · 31825
Tracheal defect repair
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
31825 without 51 · national office
$610.90
Tracheal defect repair
31825-51 · Second procedure: 50%
$305.45
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%).
31825 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31820Tracheal closure
- This code applies when fistula closure includes plastic repair; 31820 is for closure without plastic repair.
- 31800Tracheal repair
- 31800 addresses a cervical tracheal wound or injury. This code is for a tracheostomy-site fistula closure that includes plastic repair.
- 31805Tracheal repair
- 31805 addresses an intrathoracic tracheal wound or injury, not closure of a persistent tracheostomy-site fistula.
- 31830Tracheal scar revision
- 31830 is for revision of a tracheostomy scar. This code is for closure of a persistent fistula with plastic repair.
31825 billing questions
When should this code be chosen over 31820?
Use this code when the tracheostomy-site fistula closure includes plastic repair. Use 31820 for closure without plastic repair.
What documentation supports reporting it?
The operative report should identify the persistent tracheostomy-site fistula and describe the plastic repair performed, not just state that the opening was closed.
Does the 90-day global include follow-up care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. The code's descriptor and anatomy make a bilateral adjustment inappropriate.
When is an assistant at surgery payable?
Only when medical necessity for the assistant is documented. Co-surgeon and team-surgery reporting are not permitted.
How is it affected when other 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.
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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