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See a sample rate comparisonCPT 31603 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Tracheostomy Emergency Proced, Tracheostomy Emergency Procedure Transtrachealtracheostomy Emergency Procedure Transtracheal
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room 22 - On Campus Outpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31603 |
| Medicaid Fee Schedule | View Medicaid rates for 31603 |
National average reimbursement for CPT 31603 by major payers:
$365.84
$375.13
$412.40
$474.69
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CPT 31603
5 of 25 sample ratesHigher to lower in this preview
Surgicare Of Minneapolis Ltd, Surgical Specialty Center Of Minnesota
$2,025.00Published rateSouth Broward Endoscopy L L C
$1,337.00Published rateBoise Endoscopy Center, LLC
Boise Endoscopy Center LLC
$950.00Published rateAdvanced Surgery Center Of Lancaster, LLC
Advanced Surgery Center Of Lancaster LLC
$670.00Published rateThe Asc At Waugh Chapel
$228.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 31603 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31603 code is part of the Surgery services used for Surgical Procedures on the Respiratory System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 31603 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 31603-CPT | Moderate | Tracheostomy Emergency Proced, Tracheostomy Emergency Procedure Transtrachealtracheostomy Emergency Procedure Transtracheal |
| 31605-CPT | Moderate | Tracheostomy Emergency Proced, Tracheostomy Emergency Procedure Cricothyroid Membranetracheostomy Emergency Procedure Cricothyroid Membrane |
| 31610-CPT | High | Create Opening In Airway, Surgery To Create An Opening Into The Windpipe (Trachea) For Breathing. Skin Flaps May Be Used To Close The Opening. |
| 31611-CPT | Moderate | Construction Of Tracheoesophag, Construction Of Tracheoesophageal Fistula And Subsequentinsertion Of An Alaryngeal Speech Prosthesis(Eg Voice Button Blom-Singer Prosthesis) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31603. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31603 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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