How much does Medicare pay for CPT 31600?

Medicare allowed an average of $291.82 per service and paid $232.78 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1443.81, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31600?

Incision of windpipe for insertion of breathing tube (older than 2 years). It was billed 1,534 times to 1,511 Medicare beneficiaries by 95 providers in 2024.

Which specialty bills 31600 most?

Thoracic Surgery, with 380 services from 23 clinicians. Next are Otolaryngology, General Surgery, Pulmonary Disease.

CPT 31600

Incision of windpipe for insertion of breathing tube (older than 2 years)

$291.82Medicare-allowed amount per service, averaged across 1,534 services

Providers submitted

$1443.81

Asking price, not received

Medicare allowed

$291.82

The fee schedule figure

Medicare paid

$232.78

Balance is patient coinsurance

Providers submitted an average of $1443.81 for this code and Medicare allowed $291.82 — 4.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $232.78 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,534
Beneficiaries: 1,511
Providers billing it: 95
Total allowed: $447,652

What Medicare pays for CPT 31600

Across 1,534 services billed by 95 providers to 1,511 beneficiaries, Medicare allowed an average of $291.82 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 31600

Specialty	Services	Beneficiaries	Avg allowed	Providers
Thoracic Surgery	380	373	$297.13	23
Otolaryngology	370	366	$262.18	23
General Surgery	330	324	$313.20	20
Pulmonary Disease	238	237	$307.45	15
Critical Care (Intensivists)	54	54	$316.85	3
Internal Medicine	40	39	$296.67	2
Maxillofacial Surgery	29	29	$158.49	2
Cardiac Surgery	24	23	$313.17	2
General Practice	20	17	$290.23	1
Hospitalist	13	13	$281.95	1
Anesthesiology	13	13	$265.86	1
Neurology	12	12	$316.33	1
Plastic and Reconstructive Surgery	11	11	$308.75	1

31600 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	247	$284.18	$219.49	15
New York	202	$345.28	$231.76	11
Florida	119	$322.99	$235.99	8
New Jersey	98	$269.11	$194.91	7
Illinois	88	$337.53	$231.97	6
Arkansas	81	$250.89	$222.84	4
Oklahoma	67	$267.86	$223.47	4
Texas	67	$308.45	$236.55	3
Ohio	64	$270.83	$217.58	4
Pennsylvania	56	$276.10	$214.85	3
District of Columbia	41	$304.83	$235.76	2
Michigan	40	$296.01	$234.35	3
Tennessee	39	$261.70	$223.78	3
South Carolina	32	$277.40	$232.65	2
Minnesota	30	$280.67	$236.06	1
Louisiana	28	$256.29	$172.82	2
Maryland	27	$264.53	$192.22	2
Alabama	27	$194.71	$161.40	2
Massachusetts	25	$316.26	$236.40	1
Missouri	25	$256.59	$203.03	2
Georgia	23	$308.51	$236.03	2
North Carolina	18	$154.82	$131.18	1
West Virginia	17	$305.99	$235.34	1
Nevada	15	$287.49	$235.94	1
Nebraska	13	$265.86	$136.56	1
Indiana	12	$272.29	$236.38	1
Mississippi	11	$276.28	$236.01	1
Connecticut	11	$326.48	$236.00	1
Virginia	11	$270.94	$241.73	1

Related codes

31624Irrigation and suction of lung airways to obtain cells$57.02
31628Biopsy of lobe of lung$77.25
31627Computer-assisted image-guided navigation of lung airways$93.76
31629Needle biopsy of windpipe cartilage$144.37
31645Aspiration of initial secretion of lung airway$83.67
31654Exam of lung airways$64.48
31652Exam of lung airways and sampling of lymph nodes$173.21
31653Exam of lung airways and sampling of lymph nodes$221.80
31622Diagnostic exam of lung airway$108.89
31615Exam of windpipe and lung airways through permanent windpipe opening$145.91
31623Exam of lung airways$15.29
31632Biopsy of lobe of lung$47.23

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.