CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 31603 RVU and Medicare Payment (2026)
Emer tracheostomy ttrach — 5.85 work RVU, about $278.56 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 5.85
- PE RVU (non-facility)
- 1.41
- PE RVU (facility)
- 1.41
- MP RVU
- 1.08
- Office payment
- $278.56
- Facility payment
- $278.56
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 31603 in a non-facility setting with national GPCI: (5.85 + 1.41 + 1.08) × $33.4009 ≈ $278.56. The same code in a facility setting pays about $278.56 because facility PE RVU (1.41) replaces office PE RVU.
What changes by locality
GPCI moves 31603 non-facility payment from $251.62 to $363.13 across CMS localities — from Wisconsin to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 31603?
5.85. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 31603 in 2026?
About $278.56 non-facility ($278.56 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (5.85) and malpractice RVU stay fixed; only practice expense changes (1.41 office vs 1.41 facility). That is the entire office-vs-facility payment gap.