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CPT code 31531: Foreign body removal, with operating scope2026 Medicare rate & RVUs

ENT surgeons use operative direct laryngoscopy with an operating microscope or telescope to locate and remove a foreign body from the larynx.

CMS RVU26DEffective Oct 1, 2026109 payment localities119 Medicare services in 2024

Medicare pays $181.70 for 31531 nationally in a facility.

Medicare rate · 31531

Foreign body removal, with operating scope

Office or facility?

Work RVUs
3.49
Total RVUs
5.44
Global days
000

National rate · 2026

$181.70

Facility setting, before claim adjustments.

See every locality for 31531 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 31531 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 31531 covers

An otolaryngologist performs this procedure to inspect the larynx directly and remove an object using an operating microscope or telescope. It is typically done in an operating room under anesthesia when an inhaled or swallowed object is lodged in the larynx and needs operative retrieval. The operative scope supports visualization during the removal; this is not simply a diagnostic laryngeal examination.

Report the code when the operative laryngoscopy includes foreign-body removal with the operating scope. The operative note should identify the laryngeal foreign body, the direct laryngoscopic approach, scope use, and removal performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this code. An assistant at surgery is payable only when medical necessity is documented; 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 31531 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

31531 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$168.40
AlaskaUnavailable$235.63
ArizonaUnavailable$177.79
ArkansasUnavailable$166.77
Atlanta, GAUnavailable$186.18
Austin, TXUnavailable$182.84
Bakersfield, CAUnavailable$182.04
Baltimore area, MDUnavailable$191.06
Beaumont, TXUnavailable$176.16
Brazoria, TXUnavailable$178.52

31531 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
31531 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 31531 rate is calculated

Each of 31531’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 · 31531

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.49

3.49 RVUs× 1.000 GPCI

Practice expense1.45

1.45 RVUs× 1.000 GPCI

Malpractice0.50

0.50 RVUs× 1.000 GPCI

Adjusted RVUs

5.4400

Conversion factor

$33.4009

Medicare rate

$181.70

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

Payment rules and modifiers for 31531

The CMS indicators that decide how 31531 is paid alongside other services.

CMS payment indicators · 31531

Foreign body removal, with operating scope

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

31531 without 51 · national facility

$181.70

Foreign body removal, with operating scope

31531-51 · Second procedure: 50%

$90.85

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

31531 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 31531

    Foreign body removal, with operating scope3.49 wRVU

    Not priced

  • 31530

    Laryngoscopy, foreign body removal3.3 wRVU

    Not priced

  • 31511

    Laryngeal FB removal, indirect laryngoscopy2.11 wRVU

    $210.76

  • 31535

    Laryngeal biopsy, direct operative approach3.08 wRVU

    Not priced

  • 31536

    Laryngeal biopsy, with operating scope3.46 wRVU

    Not priced

How to choose

31530LaryngoscopyForeign body removal
Both are direct operative laryngoscopy services for removing a laryngeal foreign body. 31531 is distinguished by use of an operating microscope or telescope.
31511Laryngeal FB removalIndirect laryngoscopy
31511 uses an indirect laryngoscopic approach for foreign-body removal. 31531 describes direct operative laryngoscopy with an operating microscope or telescope.
31535Laryngeal biopsyDirect operative approach
31535 is for biopsy during direct operative laryngoscopy. Use 31531 when the operative objective is removal of a foreign body.
31536Laryngeal biopsyWith operating scope
31536 describes biopsy using direct operative laryngoscopy with an operating microscope or telescope; 31531 describes foreign-body removal with that scope.

Codes related to 31531

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

Codes related to 31531
CodeHow it relatesNational office range
Same family
31530Laryngoscopy, foreign body removalDirect operative laryngoscopy for foreign-body removal without the operating-scope distinction.No office rate
31535Laryngeal biopsy, direct operative approachDirect operative laryngoscopy with biopsy rather than foreign-body removal.No office rate
31536Laryngeal biopsy, with operating scopeDirect operative laryngoscopy with biopsy using an operating microscope or telescope.No office rate
31540Laryngeal excision, without operating scopeDirect operative laryngoscopy for excision of a laryngeal tumor.No office rate
Used instead
31511Laryngeal FB removal, indirect laryngoscopyIndirect laryngoscopy with foreign-body removal, rather than the direct operative approach.$187.53–$271.44

31531 billing questions

How does this differ from 31530?

Both describe direct operative laryngoscopy to remove a laryngeal foreign body. Report 31531 when an operating microscope or telescope is used; 31530 is the related service without that scope distinction.

When would 31511 be more appropriate?

31511 describes indirect laryngoscopy with foreign-body removal. Choose 31531 for operative direct laryngoscopy using an operating microscope or telescope.

Can diagnostic laryngoscopy be billed separately?

The inspection that is part of the operative foreign-body removal is integral to that service. A separate diagnostic laryngoscopy should not be reported for the same work.

What documentation supports reporting 31531?

Document the laryngeal foreign body, the direct operative approach, use of an operating microscope or telescope, and the removal performed.

How does CMS handle related endoscopies performed together?

Endoscopy family pricing applies when related endoscopies are performed together. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

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

Modifier 50 is inappropriate for this code. An assistant at surgery is payable only with documentation of medical necessity; co-surgeons and team surgery are not permitted.

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 31531PPRRVU2026_Oct_nonQPP.csv, line 3,589 (RVU26D)

Open CMS sourceHow we calculate rates

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