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CPT code 31510: Laryngoscopy, indirect approach with biopsy2026 Medicare rate & RVUs in Washington, DC area

An otolaryngologist uses an indirect laryngoscopic approach to inspect the larynx and obtain tissue from a suspicious area for biopsy.

CMS RVU26DEffective Oct 1, 2026One payment locality22 Medicare services in 2024

In Washington, DC area, Medicare pays $245.08 for 31510 in the office and $115.63 when it’s performed in a hospital or facility.

$245.08Office (non-facility)
$115.63Hospital or facility
+13.9%vs the national office rate ($215.10)

Check a contract rate as a % of Medicare · 31510 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 31510 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 31510 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 31510 covers

This service combines indirect visualization of the larynx with collection of tissue from a selected area for diagnostic examination. An otolaryngologist commonly performs it when an abnormal mucosal area or lesion needs tissue assessment, in an outpatient practice or a facility. The defining features are the indirect approach and biopsy; a diagnostic look without tissue sampling is a different service, as is a direct operative laryngoscopy.

Report the code when the documented service includes both indirect laryngeal examination and biopsy. The record should identify the indication and biopsy site, and support that tissue was obtained. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Bilateral adjustment is not appropriate. Assistant-at-surgery payment requires documentation of medical necessity; 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 Washington, DC area compares for 31510

Across 109 of 109 payment localities, the office rate for 31510 runs from $190.59 in Arkansas to $281.57 in San Benito County, CA. Washington, DC area pays $245.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

31510 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$245.08
  2. Los Angeles, CA · California$241.09−$3.99
  3. Miami, FL · Florida$234.28−$10.80
  4. Chicago, IL · Illinois$227.50−$17.58
  5. Manhattan, NY · New York$247.51+$2.43
  6. Alaska · Alaska$251.79+$6.71
  7. Alabama · Alabama$193.34−$51.74

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

31510 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$190.59$96.20
ArizonaArizona$209.39$102.91
Bakersfield, CACalifornia$226.71$106.27
Chico, CACalifornia$225.95$105.52
El Centro, CACalifornia$226.00$105.56
Fresno, CACalifornia$225.95$105.52
Hanford, CACalifornia$225.95$105.52
Madera, CACalifornia$225.95$105.52

31510 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.

$190.59

$253.76

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

View every state and territory as a table
31510 office rate range by state
State / territoryOffice rate rangeLocalities
AK$251.791
AL$193.341
AR$190.591
AZ$209.391
CA$225.95–$281.5729
CO$223.161
CT$229.261
DC$245.081
DE$212.811
FL$213.14–$234.283
GA$201.22–$219.342
GU$231.171
HI$231.171
IA$197.631
ID$199.011
IL$207.47–$227.504
IN$200.131
KS$196.971
KY$198.381
LA$198.18–$207.792
MA$221.97–$244.642
MD$216.74–$245.083
ME$200.30–$210.602
MI$203.70–$216.022
MN$213.161
MO$195.01–$208.213
MS$192.831
MT$215.081
NC$202.321
ND$209.941
NE$198.621
NH$219.921
NJ$231.69–$242.662
NM$204.901
NV$213.801
NY$205.32–$253.755
OH$202.651
OK$197.761
OR$211.95–$229.862
PA$202.82–$223.802
PR$216.561
RI$220.101
SC$202.861
SD$209.341
TN$197.981
TX$201.53–$222.598
UT$205.581
VA$210.10–$245.082
VI$216.561
VT$209.371
WA$221.47–$249.312
WI$203.051
WV$199.991
WY$212.841

See 31510 in every payment locality

How the 31510 rate is calculated

Each of 31510’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 · 31510

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.87

1.87 RVUs× 1.000 GPCI

Practice expense4.31

4.31 RVUs× 1.000 GPCI

Malpractice0.26

0.26 RVUs× 1.000 GPCI

Adjusted RVUs

6.4400

Conversion factor

$33.4009

Medicare rate

$215.10

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,577

Code
31510
Physician work
1.87
Practice expense
4.31
Malpractice
0.26

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 31510 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.87× 1.0541.9710
Practice expense4.31× 1.1785.0772
Malpractice0.26× 1.1130.2894
Total RVUs7.3375
Conversion factor× 33.4009

Office rate, Washington, DC area$245.08

Office: (1.87 × 1.054 + 4.31 × 1.178 + 0.26 × 1.113) × $33.4009 = $245.08

Facility: (1.87 × 1.054 + 1.02 × 1.178 + 0.26 × 1.113) × $33.4009 = $115.63

Open 31510 in the RVU calculator

Payment rules and modifiers for 31510

The CMS indicators that decide how 31510 is paid alongside other services.

CMS payment indicators · 31510

Laryngoscopy, indirect approach with biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
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

31510 without 51 · national office

$215.10

Laryngoscopy, indirect approach with biopsy

31510-51 · Second procedure: 50%

$107.55

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 31510

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

Codes related to 31510
CodeHow it relatesOffice range, Washington, DC area
Same family
31505Laryngoscopy, indirect, diagnosticIndirect diagnostic laryngoscopy without the biopsy included in 31510.$101.67
31511Laryngeal FB removal, indirect laryngoscopyIndirect laryngoscopy in the same group, performed to remove a laryngeal foreign body.$238.88
31512Laryngeal lesion removal, indirect laryngoscopyIndirect laryngoscopy in the same group, performed to remove a laryngeal lesion.$246.36
31513Vocal-fold injection, indirect approachIndirect laryngoscopy in the same group, performed with vocal-cord injection.No office rate
Used instead
31535Laryngeal biopsy, direct operative approachDirect operative laryngoscopy with biopsy rather than the indirect approach.No office rate
31536Laryngeal biopsy, with operating scopeDirect operative laryngoscopy with biopsy using an operating scope.No office rate

How 31510 has changed in Washington, DC area

31510 · Office / nonfacility

$245.08

Effective 2026-10-01

The base rate is $4.99 higher than on 2025-10-01, moving from $240.09 to $245.08 (2.1%).

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

    $240.09changed to$245.08

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.92 changed to 1.87
    • Practice expense RVU 4.25 changed to 4.31
    • Malpractice RVU 0.28 changed to 0.26
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $249.07changed to$240.09

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.31 changed to 4.25
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $245.00changed to$249.07

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $257.69changed to$245.00

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.32 changed to 4.31
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $262.59changed to$257.69

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.24 changed to 4.32
    • Malpractice RVU 0.25 changed to 0.27
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $262.20changed to$262.59

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.17 changed to 4.24
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $255.66changed to$262.20

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.87 changed to 4.17
    • Malpractice RVU 0.27 changed to 0.26
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $250.47changed to$255.66

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.82 changed to 3.87
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $247.16changed to$250.47

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.75 changed to 3.82

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $250.62changed to$247.16

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.83 changed to 3.75
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $250.76changed to$250.62

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.84 changed to 3.83
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $252.55changed to$250.76

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.85 changed to 3.84
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $251.30changed to$252.55

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $247.50changed to$251.30

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.82 changed to 3.85
    • Malpractice RVU 0.25 changed to 0.29
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $253.79changed to$247.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.30 changed to 3.82
    • Malpractice RVU 0.26 changed to 0.25
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $253.79

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$245.08$115.63RVU26D
2026-07-01$245.08$115.63RVU26C
2026-04-01$245.08$115.63RVU26B
2026-01-01$245.08$115.63RVU26A
2025-10-01$240.09$132.52RVU25D
2025-07-01$240.09$132.52RVU25C
2025-04-01$240.09$132.52RVU25B
2025-01-01$240.09$132.52RVU25A
2024-10-01$249.07$135.19RVU24D
2024-07-01$249.07$135.19RVU24C
2024-04-01$249.07$135.19RVU24B
2024-03-09$249.07$135.19RVU24AR
2024-01-01$245.00$132.98RVU24A
2023-10-01$257.69$138.39RVU23D
2023-07-01$257.69$138.39RVU23C
2023-04-01$257.69$138.39RVU23B
2023-01-01$257.69$138.39RVU23A
2022-10-01$262.59$138.97RVU22D
2022-07-01$262.59$138.97RVU22C
2022-04-01$262.59$138.97RVU22B
2022-01-01$262.59$138.97RVU22A
2021-10-01$262.20$138.85RVU21D
2021-07-01$262.20$138.85RVU21C
2021-04-01$262.20$138.85RVU21B
2021-01-01$262.20$138.85RVU21A
2020-10-01$255.66$140.65RVU20D
2020-07-01$255.66$140.65RVU20C
2020-04-01$255.66$140.65RVU20B
2020-01-01$255.66$140.65RVU20A
2019-10-01$250.47$139.73RVU19D
2019-07-01$250.47$139.73RVU19C
2019-04-01$250.47$139.73RVU19B
2019-01-01$250.47$139.73RVU19A
2018-10-01$247.16$139.14RVU18D
2018-07-01$247.16$139.14RVU18C
2018-04-01$247.16$139.14RVU18B
2018-01-01$247.16$139.14RVU18AR1
2017-10-01$250.62$141.21RVU17D
2017-07-01$250.62$141.21RVU17C
2017-04-01$250.62$141.21RVU17B
2017-01-01$250.62$141.21RVU17A
2016-10-01$250.76$141.60RVU16D
2016-07-01$250.76$141.60RVU16C
2016-04-01$250.76$141.60RVU16B
2016-01-01$250.76$141.60RVU16A
2015-10-01$252.55$143.44RVU15D
2015-07-01$252.55$143.44RVU15C
2015-04-01$251.30$142.72RVU15B
2015-01-01$251.30$142.72RVU15A
2014-10-01$247.50$139.85RVU14D
2014-07-01$247.50$139.85RVU14C
2014-04-01$247.50$139.85RVU14B
2014-01-01$247.50$139.85RVU14A
2013-10-01$253.79$137.62RVU13D
2013-07-01$253.79$137.62RVU13C
2013-04-01$253.79$137.62RVU13B
2013-01-01$253.79$137.62RVU13AR

Price 31510 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

31510 billing questions

How is this different from 31505?

31505 is an indirect diagnostic laryngoscopy without biopsy. Report 31510 when the indirect examination also includes tissue sampling.

When would 31535 be a better fit?

31535 describes direct operative laryngoscopy with biopsy. Use 31510 for an indirect approach, not a direct operative examination.

Can the diagnostic laryngoscopy be billed separately from the biopsy?

The indirect examination is part of the service described by 31510. Do not separately report a diagnostic laryngoscopy for the same examination.

Should modifier 50 be used for biopsies on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50 to represent bilateral work.

What documentation supports reporting 31510?

Document the reason for examination, the indirect laryngoscopic approach, the laryngeal biopsy site, and that tissue was obtained.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

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 31510PPRRVU2026_Oct_nonQPP.csv, line 3,577 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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