FeeBase
Log inGet started
Menu

CPT code 31546: Vocal fold excision, microscope with graft2026 Medicare rate & RVUs

Direct laryngoscopic removal of a vocal-fold lesion with microscope or telescope guidance and graft placement, reported when both excision and grafting are performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities19 Medicare services in 2024

Medicare pays $460.60 for 31546 nationally in a facility.

Medicare rate · 31546

Vocal fold excision, microscope with graft

Office or facility?

Work RVUs
9.49
Total RVUs
13.79
Global days
000

National rate · 2026

$460.60

Facility setting, before claim adjustments.

See every locality for 31546 →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 31546 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 31546 covers

This operative service removes a vocal-fold lesion through direct laryngoscopy, using an operating microscope or telescope, and includes placement of a graft. An otolaryngologist typically performs it in an operating room when lesion excision and graft placement are planned in the same operation. The graft is the key distinction from the related vocal-fold lesion excision without graft placement.

Report the service when the operative documentation supports lesion excision and graft placement; biopsy alone, injection, or laser destruction describes a different service. 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. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; 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 31546 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

31546 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$428.51
AlaskaUnavailable$604.90
ArizonaUnavailable$450.98
ArkansasUnavailable$424.61
Atlanta, GAUnavailable$472.31
Austin, TXUnavailable$461.69
Bakersfield, CAUnavailable$458.12
Baltimore area, MDUnavailable$483.66
Beaumont, TXUnavailable$448.54
Brazoria, TXUnavailable$452.19

31546 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
31546 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 31546 rate is calculated

Each of 31546’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 · 31546

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.49

9.49 RVUs× 1.000 GPCI

Practice expense2.93

2.93 RVUs× 1.000 GPCI

Malpractice1.37

1.37 RVUs× 1.000 GPCI

Adjusted RVUs

13.7900

Conversion factor

$33.4009

Medicare rate

$460.60

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

Payment rules and modifiers for 31546

The CMS indicators that decide how 31546 is paid alongside other services.

CMS payment indicators · 31546

Vocal fold excision, microscope with graft

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

31546 without 50 · national facility

$460.60

Vocal fold excision, microscope with graft

31546-50 · Bilateral: 150%

$690.90

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).

When to use modifier 50

31546 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 31546

    Vocal fold excision, microscope with graft9.49 wRVU

    Not priced

  • 31545

    Vocal cord excision, with operating microscope or telescope6.14 wRVU

    Not priced

  • 31541

    Tumor excision, with operating scope4.41 wRVU

    Not priced

  • 31535

    Laryngeal biopsy, direct operative approach3.08 wRVU

    Not priced

  • 31572

    Laser laryngoscopy, flexible scope, lesion destruction2.93 wRVU

    $511.70

How to choose

31545Vocal cord excisionWith operating microscope or telescope
Both address vocal-fold lesion excision with microscope or telescope guidance; 31546 is distinguished by graft placement.
31541Tumor excisionWith operating scope
31541 is used for operative excision of a tumor or vocal-cord stripping with microscope or telescope guidance; 31546 describes lesion excision with graft placement.
31535Laryngeal biopsyDirect operative approach
31535 describes laryngoscopic biopsy for tissue sampling. Choose 31546 when the documented operation includes lesion excision and graft placement.
31572Laser laryngoscopyFlexible scope, lesion destruction
31572 treats a lesion by laryngoscopic laser destruction; 31546 involves excision and graft placement.

Codes related to 31546

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

Codes related to 31546
CodeHow it relatesNational office range
Same family
31545Vocal cord excision, with operating microscope or telescopeRelated vocal-fold lesion excision without the graft placement included in this service.No office rate
Used instead
31541Tumor excision, with operating scopeOperative laryngoscopic excision for a tumor or vocal-cord stripping rather than this grafted lesion procedure.No office rate
31540Laryngeal excision, without operating scopeOperative excision for tumor or vocal-cord stripping without the microscope or telescope approach.No office rate
31535Laryngeal biopsy, direct operative approachLaryngoscopic biopsy when tissue sampling, rather than excision with graft placement, is performed.No office rate
31572Laser laryngoscopy, flexible scope, lesion destructionLaryngoscopic laser destruction of a lesion rather than excision with graft placement.$448.41–$692.37

31546 billing questions

When should I choose this code over 31545?

Use 31546 when the vocal-fold lesion is excised and a graft is placed. The related 31545 service is the excision without graft placement.

Does this code include graft placement?

Yes. Graft placement is part of the service described by this code and is what distinguishes it from the related excision code without a graft.

Can I report a biopsy or laser treatment as this service?

No. A biopsy without definitive excision, or laser destruction without excision and graft placement, describes a different service.

How should a bilateral procedure be reported?

CMS identifies this as a bilateral procedure. Modifier 50 is paid at 150%.

How are related endoscopies priced when performed together?

CMS endoscopy-family pricing applies when related endoscopies are performed together.

Can an assistant or co-surgeon be paid for this operation?

Assistant-at-surgery payment is subject to a statutory restriction. 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 31546PPRRVU2026_Oct_nonQPP.csv, line 3,595 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 31546 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 31546 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet