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CPT code 31505: Laryngoscopy, indirect, diagnostic2026 Medicare rate & RVUs in Puerto Rico

Report an indirect diagnostic laryngoscopy for mirror-based examination of the larynx, such as evaluation of persistent hoarseness or suspected vocal-fold abnormality.

CMS RVU26DEffective Oct 1, 2026One payment locality3.9K Medicare services in 2024

In Puerto Rico, Medicare pays $89.21 for 31505 in the office and $44.97 when it’s performed in a hospital or facility.

$89.21Office (non-facility)
$44.97Hospital or facility
+0.8%vs the national office rate ($88.51)

Check a contract rate as a % of Medicare · 31505 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 31505 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 31505 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 31505 covers

CPT 31505 covers an indirect diagnostic examination of the larynx, typically using a laryngeal mirror to view the vocal folds and surrounding structures. An otolaryngologist commonly performs the exam in an office or clinic when evaluating persistent hoarseness, voice change, throat symptoms, or a suspected laryngeal abnormality. It describes examination only, not biopsy, lesion removal, or another therapeutic procedure.

Report the code when the indirect examination is a distinct service, rather than an integral part of a more extensive laryngeal procedure. Document the indication, examination method, structures viewed, and findings. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur 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. Assistant-at-surgery payment is statutorily restricted; 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.

How Puerto Rico compares for 31505

Across 109 of 109 payment localities, the office rate for 31505 runs from $78.01 in Arkansas to $118.97 in San Benito County, CA. Puerto Rico pays $89.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

31505 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$89.21
  2. Los Angeles, CA · California$100.70+$11.49
  3. Washington, DC area · District of Columbia$101.67+$12.46
  4. Miami, FL · Florida$94.81+$5.60
  5. Chicago, IL · Illinois$92.01+$2.80
  6. Manhattan, NY · New York$101.91+$12.70
  7. Alaska · Alaska$101.64+$12.43

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

31505 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$79.19$40.90
ArkansasArkansas$78.01$40.42
ArizonaArizona$86.12$43.72
Bakersfield, CACalifornia$94.35$46.40
Chico, CACalifornia$94.14$46.19
El Centro, CACalifornia$94.16$46.20
Fresno, CACalifornia$94.14$46.19
Hanford, CACalifornia$94.14$46.19

31505 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$78.01

$106.56

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
31505 office rate range by state
State / territoryOffice rate rangeLocalities
AK$101.641
AL$79.191
AR$78.011
AZ$86.121
CA$94.14–$118.9729
CO$92.491
CT$94.521
DC$101.671
DE$87.581
FL$86.76–$94.813
GA$81.78–$90.102
GU$96.631
HI$96.631
IA$81.451
ID$81.961
IL$84.05–$92.254
IN$82.461
KS$80.971
KY$80.941
LA$80.77–$84.912
MA$91.88–$101.962
MD$89.32–$101.673
ME$82.31–$87.052
MI$83.03–$87.792
MN$88.791
MO$79.28–$85.333
MS$78.661
MT$88.511
NC$83.221
ND$87.121
NE$81.941
NH$90.951
NJ$95.64–$100.552
NM$83.471
NV$88.191
NY$84.49–$104.345
OH$82.751
OK$80.881
OR$87.55–$95.612
PA$82.93–$92.042
PR$89.211
RI$90.831
SC$83.111
SD$86.961
TN$81.381
TX$82.36–$92.148
UT$84.291
VA$86.70–$101.672
VI$89.211
VT$86.691
WA$91.73–$104.162
WI$84.101
WV$80.811
WY$87.901

See 31505 in every payment locality

How the 31505 rate is calculated

Each of 31505’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 · 31505

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense1.99

1.99 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

2.6500

Conversion factor

$33.4009

Medicare rate

$88.51

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,575

Code
31505
Physician work
0.59
Practice expense
1.99
Malpractice
0.07

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 31505 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0000.5900
Practice expense1.99× 1.0112.0119
Malpractice0.07× 0.9850.0690
Total RVUs2.6708
Conversion factor× 33.4009

Office rate, Puerto Rico$89.21

Office: (0.59 × 1 + 1.99 × 1.011 + 0.07 × 0.985) × $33.4009 = $89.21

Facility: (0.59 × 1 + 0.68 × 1.011 + 0.07 × 0.985) × $33.4009 = $44.97

Open 31505 in the RVU calculator

Payment rules and modifiers for 31505

The CMS indicators that decide how 31505 is paid alongside other services.

CMS payment indicators · 31505

Laryngoscopy, indirect, diagnostic

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

31505 without 51 · national office

$88.51

Laryngoscopy, indirect, diagnostic

31505-51 · Second procedure: 50%

$44.26

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%).

When to use modifier 51

Codes related to 31505

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 31505
CodeHow it relatesOffice range, Puerto Rico
Used instead
31510Laryngoscopy, indirect approach with biopsyIndirect laryngoscopy with biopsy when tissue sampling is performed.$216.56
31525Laryngoscopy, diagnostic, except newbornDiagnostic direct laryngoscopy rather than indirect mirror examination.$252.67
31575Laryngoscopy, flexible, diagnosticDiagnostic laryngoscopy performed with a flexible fiberoptic scope.$128.21
31520Laryngoscopy, diagnostic, newbornDiagnostic direct laryngoscopy for a newborn.No office rate
31535Laryngeal biopsy, direct operative approachDirect laryngoscopy with biopsy for an operative biopsy service.No office rate

How 31505 has changed in Puerto Rico

31505 · Office / nonfacility

$89.21

Effective 2026-10-01

The base rate is $3.41 higher than on 2025-10-01, moving from $85.80 to $89.21 (4.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $85.80changed to$89.21

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.61 changed to 0.59
    • Practice expense RVU 1.96 changed to 1.99
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $90.30changed to$85.80

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.01 changed to 1.96
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $88.82changed to$90.30

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $93.02changed to$88.82

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.04 changed to 2.01
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $92.51changed to$93.02

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $94.99changed to$92.51

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.03 changed to 2.04
    • Malpractice RVU 0.09 changed to 0.08
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $94.02changed to$94.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.98 changed to 2.03

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $89.98changed to$94.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.78 changed to 1.98
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $86.90changed to$89.98

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.71 changed to 1.78
    • Malpractice RVU 0.08 changed to 0.09
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $84.26changed to$86.90

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.64 changed to 1.71

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $74.42changed to$84.26

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.65 changed to 1.64
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $65.34changed to$74.42

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.69 changed to 1.65
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $65.22changed to$65.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.68 changed to 1.69
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $64.89changed to$65.22

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $64.43changed to$64.89

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.69 changed to 1.68
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $64.71changed to$64.43

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.88 changed to 1.69
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $64.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$89.21$44.97RVU26D
2026-07-01$89.21$44.97RVU26C
2026-04-01$89.21$44.97RVU26B
2026-01-01$89.21$44.97RVU26A
2025-10-01$85.80$48.66RVU25D
2025-07-01$85.80$48.66RVU25C
2025-04-01$85.80$48.66RVU25B
2025-01-01$85.80$48.66RVU25A
2024-10-01$90.30$49.74RVU24D
2024-07-01$90.30$49.74RVU24C
2024-04-01$90.30$49.74RVU24B
2024-03-09$90.30$49.74RVU24AR
2024-01-01$88.82$48.93RVU24A
2023-10-01$93.02$49.98RVU23D
2023-07-01$92.51$49.81RVU23C
2023-04-01$92.51$49.81RVU23B
2023-01-01$92.51$49.81RVU23A
2022-10-01$94.99$49.99RVU22D
2022-07-01$94.99$49.99RVU22C
2022-04-01$94.99$49.99RVU22B
2022-01-01$94.99$49.99RVU22A
2021-10-01$94.02$49.35RVU21D
2021-07-01$94.02$49.35RVU21C
2021-04-01$94.02$49.35RVU21B
2021-01-01$94.02$49.35RVU21A
2020-10-01$89.98$50.32RVU20D
2020-07-01$89.98$50.32RVU20C
2020-04-01$89.98$50.32RVU20B
2020-01-01$89.98$50.32RVU20A
2019-10-01$86.90$50.24RVU19D
2019-07-01$86.90$50.24RVU19C
2019-04-01$86.90$50.24RVU19B
2019-01-01$86.90$50.24RVU19A
2018-10-01$84.26$50.19RVU18D
2018-07-01$84.26$50.19RVU18C
2018-04-01$84.26$50.19RVU18B
2018-01-01$84.26$50.19RVU18AR1
2017-10-01$74.42$45.85RVU17D
2017-07-01$74.42$45.85RVU17C
2017-04-01$74.42$45.85RVU17B
2017-01-01$74.42$45.85RVU17A
2016-10-01$65.34$41.11RVU16D
2016-07-01$65.34$41.11RVU16C
2016-04-01$65.34$41.11RVU16B
2016-01-01$65.34$41.11RVU16A
2015-10-01$65.22$40.90RVU15D
2015-07-01$65.22$40.90RVU15C
2015-04-01$64.89$40.69RVU15B
2015-01-01$64.89$40.69RVU15A
2014-10-01$64.43$40.63RVU14D
2014-07-01$64.43$40.63RVU14C
2014-04-01$64.43$40.63RVU14B
2014-01-01$64.43$40.63RVU14A
2013-10-01$64.71$40.03RVU13D
2013-07-01$64.71$40.03RVU13C
2013-04-01$64.71$40.03RVU13B
2013-01-01$64.71$40.03RVU13AR

Price 31505 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

31505 billing questions

When should 31505 be chosen over 31525?

Use 31505 for an indirect examination, typically with a laryngeal mirror. Use 31525 when the diagnostic examination is performed by direct laryngoscopy.

Can 31505 be reported with a biopsy code?

When a biopsy is performed as part of the laryngoscopy, select the procedure code describing that service, such as 31510 for indirect laryngoscopy with biopsy. Do not separately report 31505 for an examination integral to the biopsy procedure.

How does 31505 differ from flexible laryngoscopy?

31505 describes indirect mirror examination. Use 31575 for diagnostic laryngoscopy performed with a flexible fiberoptic scope.

Does 31505 have a global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

Should modifier 50 be appended for both sides?

No. CMS indicates that bilateral adjustment does not apply and modifier 50 is inappropriate for this code.

How are multiple procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures in that session.

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
RVUs for 31505PPRRVU2026_Oct_nonQPP.csv, line 3,575 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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