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CPT code 31576: Laryngeal biopsy, flexible endoscopic approach2026 Medicare rate & RVUs in Iowa

An otolaryngologist uses a flexible scope to inspect the larynx and obtain tissue from a suspicious area for diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026One payment locality666 Medicare services in 2024

In Iowa, Medicare pays $246.44 for 31576 in the office and $95.77 when it’s performed in a hospital or facility.

$246.44Office (non-facility)
$95.77Hospital or facility
−8.2%vs the national office rate ($268.54)

Check a contract rate as a % of Medicare · 31576 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 31576 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 31576 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 31576 covers

This service involves passing a flexible endoscope to examine the larynx and taking one or more tissue samples from an abnormal area. Otolaryngologists commonly perform it in an office or facility when a vocal fold or other laryngeal finding needs tissue diagnosis. The scope provides visualization and access for the biopsy; the purpose is sampling, not removing a lesion as treatment.

Report the service when the flexible examination includes an actual tissue biopsy, and document the sampled site, endoscopic findings, and biopsy performed. Same-day preoperative and postoperative care is included in the 0-day global period. When related endoscopies are performed together, endoscopy family pricing applies. A bilateral adjustment is not appropriate. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted for this service.

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.

How Iowa compares for 31576

Across 109 of 109 payment localities, the office rate for 31576 runs from $236.36 in Arkansas to $358.97 in San Benito County, CA. Iowa pays $246.44. The RVUs are the same everywhere; the geographic indexes change the dollars.

31576 in Iowa vs other payment areas
  1. Iowa · this page$246.44
  2. Los Angeles, CA · California$304.45+$58.01
  3. Washington, DC area · District of Columbia$308.16+$61.72
  4. Miami, FL · Florida$289.96+$43.52
  5. Chicago, IL · Illinois$281.21+$34.77
  6. Manhattan, NY · New York$309.71+$63.27
  7. Alaska · Alaska$308.27+$61.83

Other areas in Iowa first, then benchmark localities. Bars start at $0.

Every other payment area

31576 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$239.97$95.89
ArkansasArkansas$236.36$94.91
ArizonaArizona$261.14$101.58
Bakersfield, CACalifornia$285.36$104.89
Chico, CACalifornia$284.61$104.13
El Centro, CACalifornia$284.65$104.17
Fresno, CACalifornia$284.61$104.13
Hanford, CACalifornia$284.61$104.13

31576 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.

$236.36

$321.79

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
31576 office rate range by state
State / territoryOffice rate rangeLocalities
AK$308.271
AL$239.971
AR$236.361
AZ$261.141
CA$284.61–$358.9729
CO$280.081
CT$286.871
DC$308.161
DE$265.591
FL$264.18–$289.963
GA$248.78–$273.652
GU$292.071
HI$292.071
IA$246.441
ID$248.091
IL$256.17–$281.214
IN$249.601
KS$245.191
KY$245.781
LA$245.36–$258.022
MA$278.28–$308.602
MD$270.83–$308.163
ME$249.39–$263.552
MI$252.40–$267.562
MN$268.181
MO$240.94–$259.043
MS$238.701
MT$268.531
NC$252.121
ND$263.381
NE$247.861
NH$275.591
NJ$290.10–$304.752
NM$253.821
NV$267.291
NY$256.04–$317.425
OH$251.351
OK$245.381
OR$265.17–$289.332
PA$251.80–$279.462
PR$270.601
RI$275.321
SC$252.161
SD$262.781
TN$246.471
TX$250.07–$279.188
UT$255.751
VA$262.62–$308.162
VI$270.601
VT$262.271
WA$277.78–$315.062
WI$254.201
WV$246.301
WY$266.291

See 31576 in every payment locality

How the 31576 rate is calculated

Each of 31576’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 · 31576

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.84

1.84 RVUs× 1.000 GPCI

Practice expense5.94

5.94 RVUs× 1.000 GPCI

Malpractice0.26

0.26 RVUs× 1.000 GPCI

Adjusted RVUs

8.0400

Conversion factor

$33.4009

Medicare rate

$268.54

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,609

Code
31576
Physician work
1.84
Practice expense
5.94
Malpractice
0.26

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 31576 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.84× 1.0001.8400
Practice expense5.94× 0.9155.4351
Malpractice0.26× 0.3970.1032
Total RVUs7.3783
Conversion factor× 33.4009

Office rate, Iowa$246.44

Office: (1.84 × 1 + 5.94 × 0.915 + 0.26 × 0.397) × $33.4009 = $246.44

Facility: (1.84 × 1 + 1.01 × 0.915 + 0.26 × 0.397) × $33.4009 = $95.77

Open 31576 in the RVU calculator

Payment rules and modifiers for 31576

The CMS indicators that decide how 31576 is paid alongside other services.

CMS payment indicators · 31576

Laryngeal biopsy, flexible endoscopic approach

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

31576 without 51 · national office

$268.54

Laryngeal biopsy, flexible endoscopic approach

31576-51 · Second procedure: 50%

$134.27

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

Codes related to 31576

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

Codes related to 31576
CodeHow it relatesOffice range, Iowa
Same family
31575Laryngoscopy, flexible, diagnosticFlexible diagnostic examination without biopsy.$116.80
31578Laryngoscopy, flexible scope, lesion removalFlexible laryngoscopy with lesion removal rather than diagnostic tissue sampling.$278.92
31579Laryngoscopy, with stroboscopyFlexible laryngeal examination with stroboscopic evaluation.$179.52
Used instead
31535Laryngeal biopsy, direct operative approachDirect laryngoscopy with biopsy when a direct rather than flexible approach is used.No office rate

How 31576 has changed in Iowa

31576 · Office / nonfacility

$246.44

Effective 2026-10-01

The base rate is $8.70 higher than on 2025-10-01, moving from $237.74 to $246.44 (3.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $237.74changed to$246.44

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.89 changed to 1.84
    • Practice expense RVU 5.84 changed to 5.94
    • Malpractice RVU 0.28 changed to 0.26
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $248.76changed to$237.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.98 changed to 5.84
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $244.70changed to$248.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $252.03changed to$244.70

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.97 changed to 5.98
    • Malpractice RVU 0.26 changed to 0.27
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $254.27changed to$252.03

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.90 changed to 5.97
    • Malpractice RVU 0.25 changed to 0.26
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $254.48changed to$254.27

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.84 changed to 5.90

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $251.57changed to$254.48

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.48 changed to 5.84
    • Malpractice RVU 0.26 changed to 0.25
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $248.26changed to$251.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.39 changed to 5.48
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $246.36changed to$248.26

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.34 changed to 5.39

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $246.26changed to$246.36

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.38 changed to 5.34
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $209.72changed to$246.26

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.97 changed to 1.89
    • Practice expense RVU 4.19 changed to 5.38
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $209.04changed to$209.72

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.14 changed to 4.19
    • Malpractice RVU 0.28 changed to 0.27

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $208.00changed to$209.04

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $209.01changed to$208.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.21 changed to 4.14
    • Malpractice RVU 0.23 changed to 0.28
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $210.47changed to$209.01

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.63 changed to 4.21
    • Malpractice RVU 0.24 changed to 0.23
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $210.47

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$246.44$95.77RVU26D
2026-07-01$246.44$95.77RVU26C
2026-04-01$246.44$95.77RVU26B
2026-01-01$246.44$95.77RVU26A
2025-10-01$237.74$107.80RVU25D
2025-07-01$237.74$107.80RVU25C
2025-04-01$237.74$107.80RVU25B
2025-01-01$237.74$107.80RVU25A
2024-10-01$248.76$110.18RVU24D
2024-07-01$248.76$110.18RVU24C
2024-04-01$248.76$110.18RVU24B
2024-03-09$248.76$110.18RVU24AR
2024-01-01$244.70$108.38RVU24A
2023-10-01$252.03$110.80RVU23D
2023-07-01$252.03$110.80RVU23C
2023-04-01$252.03$110.80RVU23B
2023-01-01$252.03$110.80RVU23A
2022-10-01$254.27$110.83RVU22D
2022-07-01$254.27$110.83RVU22C
2022-04-01$254.27$110.83RVU22B
2022-01-01$254.27$110.83RVU22A
2021-10-01$254.48$110.16RVU21D
2021-07-01$254.48$110.16RVU21C
2021-04-01$254.48$110.16RVU21B
2021-01-01$254.48$110.16RVU21A
2020-10-01$251.57$112.45RVU20D
2020-07-01$251.57$112.45RVU20C
2020-04-01$251.57$112.45RVU20B
2020-01-01$251.57$112.45RVU20A
2019-10-01$248.26$112.61RVU19D
2019-07-01$248.26$112.61RVU19C
2019-04-01$248.26$112.61RVU19B
2019-01-01$248.26$112.61RVU19A
2018-10-01$246.36$112.16RVU18D
2018-07-01$246.36$112.16RVU18C
2018-04-01$246.36$112.16RVU18B
2018-01-01$246.36$112.16RVU18AR1
2017-10-01$246.26$113.54RVU17D
2017-07-01$246.26$113.54RVU17C
2017-04-01$246.26$113.54RVU17B
2017-01-01$246.26$113.54RVU17A
2016-10-01$209.72$118.29RVU16D
2016-07-01$209.72$118.29RVU16C
2016-04-01$209.72$118.29RVU16B
2016-01-01$209.72$118.29RVU16A
2015-10-01$209.04$118.57RVU15D
2015-07-01$209.04$118.57RVU15C
2015-04-01$208.00$117.98RVU15B
2015-01-01$208.00$117.98RVU15A
2014-10-01$209.01$118.26RVU14D
2014-07-01$209.01$118.26RVU14C
2014-04-01$209.01$118.26RVU14B
2014-01-01$209.01$118.26RVU14A
2013-10-01$210.47$115.11RVU13D
2013-07-01$210.47$115.11RVU13C
2013-04-01$210.47$115.11RVU13B
2013-01-01$210.47$115.11RVU13AR

Price 31576 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

31576 billing questions

How does this differ from diagnostic flexible laryngoscopy?

This code includes tissue sampling during the flexible examination. Use diagnostic flexible laryngoscopy when the examination is performed without a biopsy.

When would a laryngoscopy code for lesion removal be more appropriate?

Use the removal service when the lesion is excised or otherwise removed as treatment. This code represents biopsy sampling for diagnosis, not therapeutic lesion removal.

What documentation supports reporting this service?

Document the laryngeal site examined, the abnormal finding, and that tissue was obtained with the flexible scope. The record should distinguish biopsy sampling from inspection alone or lesion removal.

Can modifier 50 be used for biopsies on both sides?

No. The CMS bilateral adjustment does not apply to this service, and modifier 50 is inappropriate.

How does payment work when related endoscopies are performed together?

CMS endoscopy family pricing applies when related endoscopies are performed together. The code also has a 0-day global period, so same-day preoperative and postoperative care is included.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. 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 31576PPRRVU2026_Oct_nonQPP.csv, line 3,609 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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