CPT code 31510: Laryngoscopy, indirect approach with biopsy2026 Medicare rate & RVUs in Missouri
An otolaryngologist uses an indirect laryngoscopic approach to inspect the larynx and obtain tissue from a suspicious area for biopsy.
Medicare pays $195.01–$208.21 for 31510 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
Where 31510 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$195.01 to $208.21
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $206.12 | $102.93 |
| Metropolitan St. Louis, MO | $208.21 | $103.59 |
| Rest of Missouri | $195.01 | $100.29 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
31510 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31505LaryngoscopyIndirect, diagnostic
- 31505 is an indirect diagnostic examination without biopsy. Choose 31510 when tissue is obtained during the indirect laryngoscopy.
- 31535Laryngeal biopsyDirect operative approach
- 31535 uses a direct operative approach with biopsy. 31510 is for biopsy performed through an indirect approach.
- 31536Laryngeal biopsyWith operating scope
- 31536 is a direct operative biopsy using an operating scope. The indirect approach distinguishes 31510.
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.
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