FeeBase
Log inGet started
Menu

Billing code 31365: LaryngectomyMedicare rate & RVUs

Total removal of the larynx combined with radical neck dissection, typically reported for advanced laryngeal malignancy when both procedures are performed in one operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities106 Medicare services in 2024

Medicare pays $2,216.15 for 31365 nationally in a facility.

Medicare rate · 31365

Laryngectomy

Swap in your local Medicare rate.

Work RVUs
37.84
Total RVUs
66.35
Global days
090

National rate · 2026

$2,216.15

Facility setting, before claim adjustments.

See every locality for 31365 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 31365 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 31365 covers

This operation removes the entire larynx and includes a radical neck dissection to remove cervical lymphatic tissue. Head and neck surgeons, commonly otolaryngologists, perform it in a hospital or other surgical facility, often for advanced laryngeal cancer. A permanent neck stoma provides the airway after the larynx is removed.

Report 31365 when the operative record supports both complete laryngeal removal and radical neck dissection in the same operation; total laryngectomy without that dissection is a different service. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Do not append modifier 50 for a bilateral adjustment. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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 31365 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

31365 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,038.39
Alaska*Unavailable$2,812.31
ArizonaUnavailable$2,165.15
ArkansasUnavailable$2,016.50
AtlantaUnavailable$2,270.34
AustinUnavailable$2,241.22
BakersfieldUnavailable$2,239.03
Baltimore/Surr. CntysUnavailable$2,337.06
BeaumontUnavailable$2,134.06
BrazoriaUnavailable$2,177.59

31365 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
31365 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 31365 rate is calculated

Each of 31365’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 · 31365

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 37.84Practice expense 22.82Malpractice 5.69

66.3500 adjusted RVUs×$33.4009 conversion factor=$2,216.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 31365

31365 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 31365

Laryngectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.76/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 31365

Laryngectomy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

31365 without 51 · national facility

$2,216.15

Laryngectomy

31365-51 · Second procedure: 50%

$1,108.08

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

31365 compared with similar codes

Compare codes

31365 vs 31360 vs 31367 vs 31390: national Medicare rates

Swap in your local Medicare rate.

  • 31365
    Laryngectomy · 37.84 wRVU
    —
  • 31360
    Laryngectomy · 29.16 wRVU
    —
  • 31367
    Partial laryngectomy · 29.81 wRVU
    —
  • 31390
    Laryngopharyngectomy · 41.45 wRVU
    —

How to choose

31360Laryngectomy
Both involve total laryngeal removal; 31365 includes radical neck dissection, while 31360 describes total removal without it.
31367Partial laryngectomy
31367 represents partial laryngeal removal. Choose 31365 when the operation removes the entire larynx and includes radical neck dissection.
31390Laryngopharyngectomy
31390 is associated with removal involving both the larynx and pharynx. 31365 covers total laryngeal removal with radical neck dissection.

Codes related to 31365

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

Codes related to 31365
CodeHow it relatesNational office range
Used instead
31360LaryngectomyTotal laryngectomy when a radical neck dissection is not performed.No office rate
31367Partial laryngectomyPartial laryngectomy option when the documented operation removes less than the entire larynx.No office rate
31390LaryngopharyngectomyConsider when the resection includes both the larynx and pharynx.No office rate

31365 billing questions

How does 31365 differ from 31360?

31365 includes total laryngectomy with radical neck dissection. Use 31360 for total laryngectomy without radical neck dissection.

Can the neck dissection be billed separately?

The radical neck dissection is included in 31365. Do not separately report another code for that same dissection.

Should modifier 50 be used for bilateral neck work?

No. CMS identifies bilateral adjustment as inappropriate for 31365; do not append modifier 50.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

What documentation supports 31365?

The operative report should establish complete removal of the larynx and performance of a radical neck dissection in the same session.

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 31365PPRRVU2026_Oct_nonQPP.csv, line 3,559 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 31365 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 31365 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →