CPT 31600 Surgery - Respiratory

How Much Does Planned Tracheostomy Cost?

Also known as: Planned tracheostomy (CPT 31600)

A tracheostomy, creating a surgical opening in the windpipe (trachea) through the front of the neck for breathing.

The total estimated cost of Planned Tracheostomy (CPT 31600) is $918 to $1,722, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $273.

Total Estimated Cost of Care

$918 — $1,722

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$273
Hospital Facility Fee
$820
Anesthesia (est.)
$55
Important: The physician fee of $273 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$273
Physician component only — CMS PFS 2026

Patient Guide: Planned Tracheostomy

What you need to know before your appointment

What to Expect

Under general anesthesia, the surgeon makes an incision in the front of the neck and creates an opening into the trachea. A tracheostomy tube is placed for breathing.

How Long Does It Take?

20-45 minutes

Common Reasons Doctors Order This

Prolonged mechanical ventilation, upper airway obstruction, severe neck or face trauma, need for long-term airway management

How to Prepare

This is often performed in critically ill patients. If planned, the surgeon will discuss how to care for the tracheostomy tube.

Procedures Commonly Done Together

These procedures are frequently performed alongside Planned tracheostomy

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How to Reduce Your Cost for Planned tracheostomy

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

5.42
Work RVU
1.69
Practice Expense RVU
1.07
Malpractice RVU
8.18
Total RVU

Payment = Total RVU (8.18) x CF ($33.40) = $273

Frequently Asked Questions

How much does Planned tracheostomy cost?

The Medicare facility rate for Planned tracheostomy is $273. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Planned tracheostomy cost without insurance?

Without insurance, the cost of Planned tracheostomy can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Planned tracheostomy?

Most commercial health insurance plans and Medicare cover Planned tracheostomy when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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