CPT code 31570: Vocal fold injection, direct, without optical magnification2026 Medicare rate & RVUs in California
Reports direct laryngoscopy with therapeutic injection into one or both vocal folds, such as botulinum toxin treatment for spasmodic dysphonia.
Medicare pays $356.28–$436.72 for 31570 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
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 31570 covers
An otolaryngologist performs direct laryngoscopy and injects a therapeutic agent into one or both vocal folds. A typical use is botulinum toxin treatment for spasmodic dysphonia. The code describes the direct approach without an operating microscope or telescope, unlike 31571, and is commonly furnished in an operative setting.
Select 31570 when documentation supports direct laryngeal access and therapeutic injection, rather than flexible-scope injection, lesion treatment, or a diagnostic-only examination. Document the indication, target vocal fold or folds, injected agent, approach, and therapeutic purpose. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy-family pricing applies. The descriptor covers vocal cord(s), so a bilateral adjustment is inappropriate. Medicare does not pay for an assistant at surgery for this service; 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 31570 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$356.28 to $436.72
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $357.99 | $195.82 |
| Chico, CA | $356.28 | $194.11 |
| El Centro, CA | $356.38 | $194.21 |
| Fresno, CA | $356.28 | $194.11 |
| Hanford, CA | $356.28 | $194.11 |
| Los Angeles, CA | $379.15 | $204.10 |
| Madera, CA | $356.28 | $194.11 |
| Marin County, CA | $426.93 | $218.30 |
| Merced, CA | $356.28 | $194.11 |
| Modesto, CA | $356.28 | $194.11 |
| Napa, CA | $405.61 | $210.59 |
| Oxnard, CA | $376.49 | $201.60 |
| Redding, CA | $356.28 | $194.11 |
| Rest of California | $356.28 | $194.11 |
| Riverside, CA | $362.76 | $200.59 |
| Sacramento, CA | $371.98 | $199.90 |
| Salinas, CA | $370.56 | $199.06 |
| San Benito County, CA | $436.72 | $223.35 |
| San Diego, CA | $377.90 | $200.94 |
| San Francisco, CA | $426.25 | $217.62 |
| San Luis Obispo, CA | $364.82 | $196.29 |
| Santa Clara County, CA | $433.93 | $220.57 |
| Santa Cruz, CA | $380.43 | $200.65 |
| Santa Maria, CA | $371.57 | $199.04 |
| Santa Rosa, CA | $384.14 | $202.44 |
| Stockton, CA | $356.28 | $194.11 |
| Vallejo, CA | $404.63 | $209.61 |
| Visalia, CA | $356.28 | $194.11 |
| Yuba City, CA | $356.28 | $194.11 |
How the 31570 rate is calculated
Each of 31570’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 · 31570
RVUs × geographic indexes × conversion factor
Work3.76
3.76 RVUs× 1.000 GPCI
Practice expense5.95
5.95 RVUs× 1.000 GPCI
Malpractice0.60
0.60 RVUs× 1.000 GPCI
Adjusted RVUs
10.3100
Conversion factor
$33.4009
Medicare rate
$344.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31570
The CMS indicators that decide how 31570 is paid alongside other services.
CMS payment indicators · 31570
Vocal fold injection, direct, without optical magnification
| 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) | 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 51 · payment effect
With and without the modifier
31570 without 51 · national office
$344.36
Vocal fold injection, direct, without optical magnification
31570-51 · Second procedure: 50%
$172.18
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%).
31570 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31571Vocal fold injectionMicroscope or telescope
- Use 31571 when direct laryngoscopy with injection includes an operating microscope or telescope; 31570 describes the direct approach without those optics.
- 31573LaryngoscopyTherapeutic injection
- 31573 uses flexible laryngoscopy for therapeutic injection. Choose 31570 for the direct laryngoscopic approach.
- 31574Vocal fold injectionFlexible scope, unilateral
- 31574 describes flexible laryngoscopy with injection for vocal-fold augmentation; 31570 is the direct approach with therapeutic injection.
- 31575LaryngoscopyFlexible, diagnostic
- 31575 is a diagnostic flexible laryngoscopy without therapeutic injection. It does not describe the direct laryngoscopy and injection reported with 31570.
31570 billing questions
How does 31570 differ from 31571?
Both describe direct laryngoscopy with therapeutic vocal-fold injection. Use 31571 when the procedure includes an operating microscope or telescope.
When is 31573 or 31574 a better fit?
Those codes describe flexible laryngoscopy with injection. 31573 covers therapeutic injection, including specified unilateral treatment; 31574 is for injection for vocal-fold augmentation.
Can 31570 be reported for injections into both vocal folds?
The descriptor covers injection into vocal cord(s). Do not apply a bilateral adjustment or modifier 50.
Can diagnostic laryngoscopy be billed separately with 31570?
The laryngoscopy used to perform the injection is part of the service. A separate diagnostic laryngoscopy should not represent that same procedural work.
What documentation supports 31570?
Document the therapeutic indication, direct approach, vocal fold target or targets, injected agent, and purpose of the injection.
How does payment work when related endoscopies are performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The service has a 0-day global period, and assistant-at-surgery, co-surgeon, and team-surgery billing 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
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