CPT code 31576: Laryngeal biopsy, flexible endoscopic approach2026 Medicare rate & RVUs in Illinois
An otolaryngologist uses a flexible scope to inspect the larynx and obtain tissue from a suspicious area for diagnostic evaluation.
Medicare pays $256.17–$281.21 for 31576 in the office in Illinois, from Rest of Illinois to Chicago, IL. 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 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.
Where 31576 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$256.17 to $281.21
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $281.21 | $115.72 |
| East St. Louis, IL | $261.48 | $109.98 |
| Rest of Illinois | $256.17 | $105.83 |
| Suburban Chicago, IL | $281.03 | $111.92 |
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
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.
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
| 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
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%).
31576 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31575LaryngoscopyFlexible, diagnostic
- 31575 covers flexible laryngeal examination without tissue sampling. Report 31576 when a biopsy is performed during the flexible examination.
- 31578LaryngoscopyFlexible scope, lesion removal
- 31578 is for flexible endoscopic removal of a lesion. Choose 31576 when tissue is sampled for diagnosis rather than the lesion being removed as treatment.
- 31535Laryngeal biopsyDirect operative approach
- 31535 describes biopsy using direct laryngoscopy. 31576 is the flexible endoscopic approach.
- 31579LaryngoscopyWith stroboscopy
- 31579 involves stroboscopic examination of laryngeal function. 31576 is distinguished by obtaining tissue for biopsy.
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
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