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CPT code 31536: Laryngeal biopsy, with operating scope2026 Medicare rate & RVUs

An otolaryngologist uses an operating scope during direct laryngoscopy to biopsy a laryngeal lesion, such as a suspicious vocal fold abnormality.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.6K Medicare services in 2024

Medicare pays $179.03 for 31536 nationally in a facility.

Medicare rate · 31536

Laryngeal biopsy, with operating scope

Office or facility?

Work RVUs
3.46
Total RVUs
5.36
Global days
000

National rate · 2026

$179.03

Facility setting, before claim adjustments.

See every locality for 31536 →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 31536 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 31536 covers

An otolaryngologist uses a direct laryngoscope with an operating telescope or microscope to inspect the larynx and take tissue from a lesion for examination. Common indications include a suspicious vocal fold or laryngeal mucosal abnormality, such as a persistent lesion requiring histologic diagnosis. The procedure is commonly performed in an operating room, often under general anesthesia; the specimen is sent for pathology review.

Report this code when the operative scope is used and tissue is sampled for biopsy, rather than when the primary service is diagnostic visualization alone or definitive lesion excision. The operative note should identify the laryngeal site, lesion, biopsy performed, and use of the scope. CMS assigns a 0-day global period, including same-day preoperative and postoperative care. Related endoscopies performed together are subject to endoscopy-family pricing. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and 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 31536 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

31536 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$166.04
AlaskaUnavailable$232.53
ArizonaUnavailable$175.21
ArkansasUnavailable$164.45
Atlanta, GAUnavailable$183.42
Austin, TXUnavailable$180.13
Bakersfield, CAUnavailable$179.35
Baltimore area, MDUnavailable$188.19
Beaumont, TXUnavailable$173.63
Brazoria, TXUnavailable$175.93

31536 rates by state

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

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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.

View every state and territory as a table
31536 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 31536 rate is calculated

Each of 31536’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 · 31536

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.46

3.46 RVUs× 1.000 GPCI

Practice expense1.41

1.41 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

5.3600

Conversion factor

$33.4009

Medicare rate

$179.03

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

Payment rules and modifiers for 31536

The CMS indicators that decide how 31536 is paid alongside other services.

CMS payment indicators · 31536

Laryngeal biopsy, 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)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

31536 without 51 · national facility

$179.03

Laryngeal biopsy, with operating scope

31536-51 · Second procedure: 50%

$89.52

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

31536 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 31536

    Laryngeal biopsy, with operating scope3.46 wRVU

    Not priced

  • 31535

    Laryngeal biopsy, direct operative approach3.08 wRVU

    Not priced

  • 31526

    Diagnostic laryngoscopy, operating microscope or telescope2.51 wRVU

    Not priced

  • 31541

    Tumor excision, with operating scope4.41 wRVU

    Not priced

How to choose

31535Laryngeal biopsyDirect operative approach
Both describe operative laryngeal biopsy; this code is distinguished by use of an operating telescope or microscope.
31526Diagnostic laryngoscopyOperating microscope or telescope
31526 is for diagnostic direct laryngoscopy with an operating scope. This code includes biopsy of laryngeal tissue.
31541Tumor excisionWith operating scope
Use 31541 when the operative service is laryngeal tumor excision with an operating scope; this code represents biopsy rather than excision.

Codes related to 31536

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

Codes related to 31536
CodeHow it relatesNational office range
Same family
31535Laryngeal biopsy, direct operative approachRelated operative laryngeal biopsy code without the operating-scope distinction.No office rate
Used instead
31526Diagnostic laryngoscopy, operating microscope or telescopeDiagnostic direct laryngoscopy with an operating scope, without a biopsy service.No office rate
31540Laryngeal excision, without operating scopeFor laryngeal tumor excision when the service is excision rather than biopsy.No office rate
31541Tumor excision, with operating scopeLaryngeal tumor excision using an operating scope, rather than biopsy.No office rate

31536 billing questions

When should this code be chosen instead of 31535?

Choose this code when the laryngeal biopsy is performed with an operating telescope or microscope. Code 31535 describes the related biopsy service without that scope distinction.

Does taking a biopsy include definitive removal of the lesion?

A biopsy samples tissue for diagnosis. When the operative service is excision of a laryngeal tumor or lesion rather than biopsy, consider the applicable excision code, such as 31541 when an operating scope is used.

Can modifier 50 be reported for biopsies on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.

What should the operative note document?

Document the laryngeal site and lesion, the tissue sampling, and use of the operating telescope or microscope. The record should make clear that the service was a biopsy rather than diagnostic inspection alone or definitive excision.

How does CMS handle other endoscopies performed in the same session?

When related endoscopies are performed together, CMS applies endoscopy-family pricing. Payment is not determined as though each related endoscopy were an independent procedure.

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 31536PPRRVU2026_Oct_nonQPP.csv, line 3,591 (RVU26D)

Open CMS sourceHow we calculate rates

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