CPT code 31535: Laryngeal biopsy, direct operative approach2026 Medicare rate & RVUs

Medicare pays $161.99 for 31535 nationally in a facility.

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

What 31535 covers

An otolaryngologist performs a direct operative examination of the larynx and takes a tissue sample from a lesion or abnormal area for diagnostic evaluation. The service is commonly performed in an operating room, often under anesthesia, when a lesion needs tissue diagnosis. Examples include sampling a suspicious vocal fold or other laryngeal lesion; the code reflects biopsy, not complete removal of the lesion.

Select this code when the operative service includes direct laryngoscopy and tissue sampling. The operative report should identify the laryngeal site, describe the lesion and approach, and document that tissue was obtained. CMS assigns a zero-day global period, so same-day preoperative and postoperative care is included. Endoscopy-family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; 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 31535 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

31535 rates by state

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

How the 31535 rate is calculated

Each of 31535’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.

Payment rules and modifiers for 31535

The CMS indicators that decide how 31535 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

31535 compared with similar codes

How to choose

31536Laryngeal biopsyWith operating scope

Both describe direct operative laryngoscopy with biopsy. Choose 31536 when the documented procedure uses an operating microscope or telescope.

31540Laryngeal excisionWithout operating scope

31535 reports biopsy sampling for diagnosis; 31540 applies when the operative service excises a laryngeal lesion or tumor.

31525LaryngoscopyDiagnostic, except newborn

31525 is direct diagnostic laryngoscopy without tissue sampling. Report 31535 when a biopsy is obtained during the operative examination.

31510LaryngoscopyIndirect approach with biopsy

31510 describes biopsy by indirect laryngoscopy. 31535 is for the direct operative approach.

Codes related to 31535

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

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

Open CMS sourceHow we calculate rates