CPT code 31531: Foreign body removal, with operating scope2026 Medicare rate & RVUs in Missouri
ENT surgeons use operative direct laryngoscopy with an operating microscope or telescope to locate and remove a foreign body from the larynx.
CMS doesn’t publish an office rate for 31531 in Missouri.
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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $178.36 |
| Metropolitan St. Louis, MO | Unavailable | $179.41 |
| Rest of Missouri | Unavailable | $174.58 |
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
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
| 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
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%).
31531 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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