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Billing code 31513: Vocal-fold injectionMedicare rate & RVUs

Reports therapeutic injection into a vocal fold under indirect laryngoscopic visualization, commonly to improve glottic closure in vocal-fold paralysis or atrophy.

CMS RVU26DEffective Oct 1, 2026109 payment localities104 Medicare services in 2024

Medicare pays $113.56 for 31513 nationally in a facility.

Medicare rate · 31513

Vocal-fold injection

Swap in your local Medicare rate.

Work RVUs
2.05
Total RVUs
3.40
Global days
000

National rate · 2026

$113.56

Facility setting, before claim adjustments.

See every locality for 31513 → · 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 31513 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 31513 covers

An otolaryngologist uses indirect laryngoscopic visualization while injecting material into a vocal fold to improve closure and voice function. Common clinical reasons include vocal-fold paralysis or atrophy causing glottic insufficiency. The service may be performed in an office or facility; the record should identify the indication, injection site and approach, and the material used when known.

Select this code when the therapeutic injection is performed with an indirect approach, rather than direct laryngoscopy. Document the treatment and visualization performed; diagnostic visualization alone does not support the injection service. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this code. An assistant at surgery is paid only when medical necessity is documented; 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 31513 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

31513 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$104.93
Alaska*Unavailable$145.75
ArizonaUnavailable$111.07
ArkansasUnavailable$103.87
AtlantaUnavailable$116.28
AustinUnavailable$114.65
BakersfieldUnavailable$114.48
Baltimore/Surr. CntysUnavailable$119.54
BeaumontUnavailable$109.69
BrazoriaUnavailable$111.66

31513 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
31513 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 31513 rate is calculated

Each of 31513’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 · 31513

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.05Practice expense 1.06Malpractice 0.29

3.4000 adjusted RVUs×$33.4009 conversion factor=$113.56

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

Payment rules and modifiers for 31513

The CMS indicators that decide how 31513 is paid alongside other services.

CMS payment indicators · 31513

Vocal-fold injection

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)0Not paid without supporting documentation.
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

31513 without 51 · national facility

$113.56

Vocal-fold injection

31513-51 · Second procedure: 50%

$56.78

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

31513 compared with similar codes

Compare codes

31513 vs 31505 vs 31570 vs 31571: national Medicare rates

Swap in your local Medicare rate.

  • 31513
    Vocal-fold injection · 2.05 wRVU
    —
  • 31505
    Laryngoscopy · 0.59 wRVU
    $88.51
  • 31570
    Vocal fold injection · 3.76 wRVU
    $344.36
  • 31571
    Vocal fold injection · 4.15 wRVU
    —

How to choose

31505Laryngoscopy
31505 is for diagnostic indirect laryngoscopy. Choose 31513 when therapeutic vocal-fold injection is performed.
31570Vocal fold injection
31570 uses direct laryngoscopy for therapeutic injection; 31513 is the indirect approach.
31571Vocal fold injection
31571 is a direct laryngoscopic injection performed with an operating microscope or telescope; 31513 describes the indirect approach.

Codes related to 31513

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

Codes related to 31513
CodeHow it relatesNational office range
Same family
31505LaryngoscopyRelated indirect laryngoscopy service for diagnostic visualization without therapeutic vocal-fold injection.$78.01–$118.97
31510LaryngoscopyIndirect laryngoscopy with biopsy, rather than injection treatment.$190.59–$281.57
Used instead
31570Vocal fold injectionUse for therapeutic vocal-fold injection performed with direct laryngoscopy.$306.62–$436.72
31571Vocal fold injectionDirect laryngoscopic vocal-fold injection using an operating microscope or telescope.No office rate

31513 billing questions

When should this code be chosen instead of 31570?

Use 31513 for vocal-fold injection performed with indirect laryngoscopy. Code 31570 describes injection performed using direct laryngoscopy.

Does bilateral injection require modifier 50?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for its descriptor or anatomy.

What documentation supports reporting the injection?

Document the clinical reason for treatment, the vocal-fold site, the injection performed, and the indirect laryngoscopic visualization and approach.

Can a related endoscopy be separately reported at the same session?

When related endoscopies are performed together, CMS endoscopy family pricing applies. Report the services performed, with documentation supporting each service.

Is same-day preoperative or postoperative care separately included?

The 0-day global period includes same-day preoperative and postoperative care in the procedure.

What applies if an assistant or another surgeon participates?

Assistant-at-surgery payment requires documentation of medical necessity. 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 31513PPRRVU2026_Oct_nonQPP.csv, line 3,580 (RVU26D)

Open CMS sourceHow we calculate rates

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