CPT code 31574: Vocal fold injection, flexible scope, unilateral2026 Medicare rate & RVUs in Missouri
A laryngologist uses flexible endoscopic guidance to inject augmentation material into one vocal fold, commonly to improve glottic closure and voice.
Medicare pays $789.64–$862.94 for 31574 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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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On this page 9 sections
What 31574 covers
An otolaryngologist or laryngologist passes a flexible laryngoscope to visualize the vocal folds and injects material to add bulk to one fold. This is commonly performed for glottic insufficiency, such as when vocal fold paralysis, paresis, or atrophy leaves an incomplete closure affecting voice or airway protection. The procedure may be performed in an office or facility, using an approach such as transoral or percutaneous injection.
Report this code for augmentation of one vocal fold under flexible endoscopic guidance, not for a diagnostic examination alone or an injection with a different therapeutic purpose. The record should identify the treated side, indication, injection approach, and augmentation performed. For bilateral treatment, CMS pays with modifier 50 at 150%. When related endoscopies are performed together, endoscopy family pricing applies. The 0-day global period includes same-day preoperative and postoperative care. Assistant-at-surgery payment requires documentation of medical necessity; 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 31574 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$789.64 to $862.94
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $852.10 | $126.66 |
| Metropolitan St. Louis, MO | $862.94 | $127.46 |
| Rest of Missouri | $789.64 | $123.69 |
How the 31574 rate is calculated
Each of 31574’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 · 31574
RVUs × geographic indexes × conversion factor
Work2.37
2.37 RVUs× 1.000 GPCI
Practice expense24.27
24.27 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
27.0000
Conversion factor
$33.4009
Medicare rate
$901.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31574
The CMS indicators that decide how 31574 is paid alongside other services.
CMS payment indicators · 31574
Vocal fold injection, flexible scope, unilateral
| 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) | 0 | Not paid without supporting documentation. |
| 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
31574 without 50 · national office
$901.82
Vocal fold injection, flexible scope, unilateral
31574-50 · Bilateral: 150%
$1,352.73
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).
31574 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31570Vocal fold injectionDirect, without optical magnification
- This code uses flexible laryngoscopy for vocal fold augmentation. Code 31570 uses direct laryngoscopy with injection.
- 31571Vocal fold injectionMicroscope or telescope
- This code is performed with flexible endoscopic guidance. Code 31571 uses direct laryngoscopy with injection and optical magnification.
- 31573LaryngoscopyTherapeutic injection
- Choose this code for augmentation intended to add vocal fold bulk. Code 31573 is for flexible laryngoscopy with a therapeutic injection, such as chemodenervation.
- 31591LaryngoplastyUnilateral medialization
- This code describes injection augmentation under flexible endoscopic guidance. Code 31591 describes medialization laryngoplasty, a surgical procedure rather than an injection.
31574 billing questions
When is this code appropriate instead of 31573?
Use this code for injection intended to augment a vocal fold, typically to improve closure. Code 31573 describes flexible laryngoscopy with a therapeutic injection, such as chemodenervation, rather than augmentation.
How should bilateral vocal fold augmentation be reported?
Report the bilateral procedure with modifier 50. CMS pays the bilateral procedure at 150%.
Can a diagnostic laryngoscopy be billed separately during the injection?
The flexible scope is used to guide the augmentation procedure. Do not separately report a diagnostic scope for the same examination work.
What documentation supports the service?
Document the indication for augmentation, the vocal fold treated, the flexible endoscopic guidance, and the injection approach and service performed.
How does the global period affect same-day care?
This procedure has a 0-day global period. Same-day preoperative and postoperative care is included.
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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