CPT code 31545: Vocal cord excision, with operating microscope or telescope2026 Medicare rate & RVUs in Michigan
Reports operative removal of vocal fold lesion(s) through direct laryngoscopy using an operating microscope or telescope, such as excision of a polyp or cyst.
CMS doesn’t publish an office rate for 31545 in Michigan.
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 31545 covers
An otolaryngologist performs this operative laryngoscopy to remove lesion(s) from a vocal fold while viewing the larynx through an operating microscope or telescope. Typical cases include microlaryngeal excision of a vocal fold polyp or cyst in a patient with persistent hoarseness. The service is commonly performed in an operating room, often in a hospital or ambulatory surgery center, rather than as an office examination.
Report the code when the documented service includes operative excision of vocal cord lesion(s) with the specified magnified endoscopic visualization. The operative report should identify the lesion and vocal fold site, describe the excision, and document use of the microscope or telescope; a biopsy-only service or destruction rather than excision points to a different code. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. For a bilateral procedure, modifier 50 is paid at 150%. 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 31545 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $323.77 |
| Rest of Michigan | Unavailable | $303.36 |
How the 31545 rate is calculated
Each of 31545’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 · 31545
RVUs × geographic indexes × conversion factor
Work6.14
6.14 RVUs× 1.000 GPCI
Practice expense2.11
2.11 RVUs× 1.000 GPCI
Malpractice0.90
0.90 RVUs× 1.000 GPCI
Adjusted RVUs
9.1500
Conversion factor
$33.4009
Medicare rate
$305.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31545
The CMS indicators that decide how 31545 is paid alongside other services.
CMS payment indicators · 31545
Vocal cord excision, with operating microscope or telescope
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 50 · payment effect
With and without the modifier
31545 without 50 · national facility
$305.62
Vocal cord excision, with operating microscope or telescope
31545-50 · Bilateral: 150%
$458.43
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
31545 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31535Laryngeal biopsyDirect operative approach
- 31535 is for obtaining a biopsy during operative laryngoscopy. Choose 31545 when the documented service removes the vocal fold lesion under magnified visualization.
- 31541Tumor excisionWith operating scope
- 31541 describes operative removal of a tumor or vocal cord stripping with an operating microscope or telescope. This code is specific to excision of vocal cord lesion(s).
- 31572Laser laryngoscopyFlexible scope, lesion destruction
- 31572 is for laser destruction of a laryngeal lesion. This code is for excision of vocal cord lesion(s), not destruction.
- 31546Vocal fold excisionMicroscope with graft
- 31546 is the related vocal cord lesion procedure involving reconstruction, such as grafting; 31545 describes excision without that reconstructive element.
31545 billing questions
When should this code be chosen instead of a laryngoscopy biopsy code?
Use this code when the surgeon excises a vocal fold lesion under an operating microscope or telescope. A service limited to obtaining tissue for diagnosis is a biopsy service.
How does this differ from laser destruction of a vocal fold lesion?
This code represents excision of lesion tissue under magnified operative visualization. A service that destroys a lesion with laser rather than excising it is represented by the laser-destruction code.
What should the operative note support?
Document the vocal fold site and lesion, the operative excision performed, and use of an operating microscope or telescope. State whether the procedure was unilateral or bilateral.
How is a bilateral procedure reported?
CMS pays a bilateral procedure reported with modifier 50 at 150%. The documentation should support treatment on both sides.
Can an assistant surgeon or co-surgeon be paid for this procedure?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another related endoscopy is performed at the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Report the services performed, with documentation distinguishing each 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
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