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CPT code 31525: Laryngoscopy, diagnostic, except newborn2026 Medicare rate & RVUs in Puerto Rico

Reports direct examination of the larynx, with or without tracheoscopy, to evaluate a suspected airway or voice disorder in a non-newborn patient.

CMS RVU26DEffective Oct 1, 2026One payment locality50.5K Medicare services in 2024

In Puerto Rico, Medicare pays $252.67 for 31525 in the office and $137.85 when it’s performed in a hospital or facility.

$252.67Office (non-facility)
$137.85Hospital or facility
+0.6%vs the national office rate ($251.17)

Check a contract rate as a % of Medicare · 31525 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 31525 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 31525 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 31525 covers

An otolaryngologist uses a laryngoscope to directly inspect the larynx and, when needed, the trachea. The examination can help assess hoarseness, suspected vocal-fold abnormalities, or other laryngeal findings that need direct visualization. It is commonly performed in a hospital or ambulatory surgical setting, often with anesthesia, although the clinical setting depends on the patient and examination plan.

Report this code for a diagnostic direct examination in a patient who is not a newborn. The operative note should identify the indication, the structures examined, and whether tracheoscopy was performed. When the same session includes a separately coded operative laryngeal service, report the code describing that work rather than separately reporting the diagnostic examination. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one 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 restricted, and co-surgeon and team-surgery billing 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 31525

Across 109 of 109 payment localities, the office rate for 31525 runs from $223.45 in Arkansas to $322.31 in San Benito County, CA. Puerto Rico pays $252.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

31525 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$252.67
  2. Los Angeles, CA · California$278.41+$25.74
  3. Washington, DC area · District of Columbia$284.46+$31.79
  4. Miami, FL · Florida$276.85+$24.18
  5. Chicago, IL · Illinois$268.97+$16.30
  6. Manhattan, NY · New York$288.87+$36.20
  7. Alaska · Alaska$298.17+$45.50

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

Every other payment area

31525 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$226.54$127.18
ArkansasArkansas$223.45$125.90
ArizonaArizona$244.60$134.56
Bakersfield, CACalifornia$262.52$138.06
Chico, CACalifornia$261.42$136.96
El Centro, CACalifornia$261.49$137.02
Fresno, CACalifornia$261.42$136.96
Hanford, CACalifornia$261.42$136.96

31525 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.

$223.45

$298.17

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

View every state and territory as a table
31525 office rate range by state
State / territoryOffice rate rangeLocalities
AK$298.171
AL$226.541
AR$223.451
AZ$244.601
CA$261.42–$322.3129
CO$259.211
CT$267.331
DC$284.461
DE$248.481
FL$250.83–$276.853
GA$237.09–$256.432
GU$266.791
HI$266.791
IA$230.521
ID$232.251
IL$245.01–$268.974
IN$233.481
KS$230.191
KY$233.121
LA$233.05–$243.882
MA$258.07–$282.962
MD$252.82–$284.463
ME$234.14–$245.112
MI$239.50–$254.532
MN$246.681
MO$229.73–$243.863
MS$226.601
MT$251.151
NC$236.341
ND$243.641
NE$231.501
NH$255.861
NJ$269.90–$281.902
NM$241.031
NV$249.211
NY$239.76–$296.445
OH$237.971
OK$231.981
OR$246.79–$266.272
PA$237.93–$261.442
PR$252.671
RI$256.481
SC$237.641
SD$242.751
TN$231.381
TX$236.51–$258.778
UT$240.701
VA$244.84–$284.462
VI$252.671
VT$243.371
WA$257.36–$287.852
WI$235.971
WV$236.611
WY$247.871

See 31525 in every payment locality

How the 31525 rate is calculated

Each of 31525’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 · 31525

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.56

2.56 RVUs× 1.000 GPCI

Practice expense4.58

4.58 RVUs× 1.000 GPCI

Malpractice0.38

0.38 RVUs× 1.000 GPCI

Adjusted RVUs

7.5200

Conversion factor

$33.4009

Medicare rate

$251.17

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

3,583

Code
31525
Physician work
2.56
Practice expense
4.58
Malpractice
0.38

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 31525 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.56× 1.0002.5600
Practice expense4.58× 1.0114.6304
Malpractice0.38× 0.9850.3743
Total RVUs7.5647
Conversion factor× 33.4009

Office rate, Puerto Rico$252.67

Office: (2.56 × 1 + 4.58 × 1.011 + 0.38 × 0.985) × $33.4009 = $252.67

Facility: (2.56 × 1 + 1.18 × 1.011 + 0.38 × 0.985) × $33.4009 = $137.85

Open 31525 in the RVU calculator

Payment rules and modifiers for 31525

The CMS indicators that decide how 31525 is paid alongside other services.

CMS payment indicators · 31525

Laryngoscopy, diagnostic, except newborn

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

31525 without 51 · national office

$251.17

Laryngoscopy, diagnostic, except newborn

31525-51 · Second procedure: 50%

$125.59

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 31525

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

Codes related to 31525
CodeHow it relatesOffice range, Puerto Rico
Used instead
31505Laryngoscopy, indirect, diagnosticDiagnostic indirect laryngoscopy uses a different visualization method.$89.21
Same family
31520Laryngoscopy, diagnostic, newbornDiagnostic direct laryngoscopy for a newborn.No office rate
31526Diagnostic laryngoscopy, operating microscope or telescopeDiagnostic direct laryngoscopy with an operating microscope or telescope.No office rate

How 31525 has changed in Puerto Rico

31525 · Office / nonfacility

$252.67

Effective 2026-10-01

The base rate is $9.61 higher than on 2025-10-01, moving from $243.06 to $252.67 (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

    $243.06changed to$252.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.63 changed to 2.56
    • Practice expense RVU 4.47 changed to 4.58
    • Malpractice RVU 0.39 changed to 0.38
    • 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

    $251.81changed to$243.06

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.52 changed to 4.47

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $247.70changed to$251.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $256.20changed to$247.70

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.53 changed to 4.52
    • Malpractice RVU 0.37 changed to 0.39
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $255.17changed to$256.20

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

  6. January 1, 2023

    RVU23A

    $259.55changed to$255.17

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.45 changed to 4.53
    • Malpractice RVU 0.39 changed to 0.37
    • 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

    $259.61changed to$259.55

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.41 changed to 4.45
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $259.08changed to$259.61

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.15 changed to 4.41
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $257.51changed to$259.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.13 changed to 4.15
    • Malpractice RVU 0.36 changed to 0.37
    • 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

    $256.86changed to$257.51

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.11 changed to 4.13
    • Malpractice RVU 0.37 changed to 0.36

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $231.86changed to$256.86

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.19 changed to 4.11
    • Malpractice RVU 0.38 changed to 0.37
    • 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

    $205.68changed to$231.86

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.26 changed to 4.19
    • 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

    $205.41changed to$205.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.22 changed to 4.26

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $204.39changed to$205.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $203.52changed to$204.39

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.28 changed to 4.22
    • Malpractice RVU 0.33 changed to 0.38
    • 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

    $200.32changed to$203.52

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.68 changed to 4.28
    • Malpractice RVU 0.34 changed to 0.33
    • 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: $200.32

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$252.67$137.85RVU26D
2026-07-01$252.67$137.85RVU26C
2026-04-01$252.67$137.85RVU26B
2026-01-01$252.67$137.85RVU26A
2025-10-01$243.06$155.76RVU25D
2025-07-01$243.06$155.76RVU25C
2025-04-01$243.06$155.76RVU25B
2025-01-01$243.06$155.76RVU25A
2024-10-01$251.81$159.63RVU24D
2024-07-01$251.81$159.63RVU24C
2024-04-01$251.81$159.63RVU24B
2024-03-09$251.81$159.63RVU24AR
2024-01-01$247.70$157.02RVU24A
2023-10-01$256.20$160.90RVU23D
2023-07-01$255.17$160.63RVU23C
2023-04-01$255.17$160.63RVU23B
2023-01-01$255.17$160.63RVU23A
2022-10-01$259.55$162.58RVU22D
2022-07-01$259.55$162.58RVU22C
2022-04-01$259.55$162.58RVU22B
2022-01-01$259.55$162.58RVU22A
2021-10-01$259.61$161.13RVU21D
2021-07-01$259.61$161.13RVU21C
2021-04-01$259.61$161.13RVU21B
2021-01-01$259.61$161.13RVU21A
2020-10-01$259.08$164.86RVU20D
2020-07-01$259.08$164.86RVU20C
2020-04-01$259.08$164.86RVU20B
2020-01-01$259.08$164.86RVU20A
2019-10-01$257.51$164.60RVU19D
2019-07-01$257.51$164.60RVU19C
2019-04-01$257.51$164.60RVU19B
2019-01-01$257.51$164.60RVU19A
2018-10-01$256.86$164.42RVU18D
2018-07-01$256.86$164.42RVU18C
2018-04-01$256.86$164.42RVU18B
2018-01-01$256.86$164.42RVU18AR1
2017-10-01$231.86$152.30RVU17D
2017-07-01$231.86$152.30RVU17C
2017-04-01$231.86$152.30RVU17B
2017-01-01$231.86$152.30RVU17A
2016-10-01$205.68$139.55RVU16D
2016-07-01$205.68$139.55RVU16C
2016-04-01$205.68$139.55RVU16B
2016-01-01$205.68$139.55RVU16A
2015-10-01$205.41$139.55RVU15D
2015-07-01$205.41$139.55RVU15C
2015-04-01$204.39$138.85RVU15B
2015-01-01$204.39$138.85RVU15A
2014-10-01$203.52$138.82RVU14D
2014-07-01$203.52$138.82RVU14C
2014-04-01$203.52$138.82RVU14B
2014-01-01$203.52$138.82RVU14A
2013-10-01$200.32$133.65RVU13D
2013-07-01$200.32$133.65RVU13C
2013-04-01$200.32$133.65RVU13B
2013-01-01$200.32$133.65RVU13AR

Price 31525 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

31525 billing questions

How does 31525 differ from 31505?

31525 describes direct laryngoscopy. 31505 is an indirect diagnostic laryngoscopy, so the method of visualization determines which code fits.

When is 31526 more appropriate?

Use 31526 when the diagnostic direct examination is performed with an operating microscope or telescope. 31525 describes the diagnostic examination without that distinguishing equipment.

Can 31525 be reported with a laryngeal biopsy code?

When biopsy or another operative laryngeal service is performed during the same examination, report the code that describes that operative service rather than separately reporting the diagnostic examination.

Does 31525 have a global period?

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

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this code. CMS restricts assistant-at-surgery payment, and co-surgeon and team-surgery billing are not permitted.

How does CMS handle 31525 when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.

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 31525PPRRVU2026_Oct_nonQPP.csv, line 3,583 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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