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Billing code 31540: Laryngeal excisionMedicare rate & RVUs

Reports direct operative laryngoscopy to excise a laryngeal tumor, such as a mass on a vocal cord or epiglottis, during a surgical encounter.

CMS RVU26DEffective Oct 1, 2026109 payment localities453 Medicare services in 2024

Medicare pays $205.42 for 31540 nationally in a facility.

Medicare rate · 31540

Laryngeal excision

Swap in your local Medicare rate.

Work RVUs
4.02
Total RVUs
6.15
Global days
000

National rate · 2026

$205.42

Facility setting, before claim adjustments.

See every locality for 31540 → · 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 31540 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 31540 covers

An otolaryngologist performs this direct operative laryngoscopy to reach and excise a tumor in the larynx. The procedure is commonly performed in a facility operating room, with the patient under anesthesia. The surgeon may remove a visible mass from a vocal cord or epiglottis and submit the excised tissue for examination. The code distinguishes tumor excision from a laryngoscopy performed only to obtain a biopsy.

Report the service when the operative record supports excision of a laryngeal tumor, rather than sampling alone. Document the lesion’s location, the direct laryngoscopic approach, and the work performed; use the related code for the operating-microscope or telescope version when that technique is documented. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. CMS does not apply a bilateral adjustment, and modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; 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 31540 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

31540 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$190.54
Alaska*Unavailable$267.22
ArizonaUnavailable$201.02
ArkansasUnavailable$188.72
AtlantaUnavailable$210.54
AustinUnavailable$206.48
BakersfieldUnavailable$205.36
Baltimore/Surr. CntysUnavailable$215.93
BeaumontUnavailable$199.38
BrazoriaUnavailable$201.76

31540 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
31540 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 31540 rate is calculated

Each of 31540’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 · 31540

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.02Practice expense 1.55Malpractice 0.58

6.1500 adjusted RVUs×$33.4009 conversion factor=$205.42

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

Payment rules and modifiers for 31540

The CMS indicators that decide how 31540 is paid alongside other services.

CMS payment indicators · 31540

Laryngeal excision

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

31540 without 51 · national facility

$205.42

Laryngeal excision

31540-51 · Second procedure: 50%

$102.71

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

31540 compared with similar codes

Compare codes

31540 vs 31541 vs 31535 vs 31536: national Medicare rates

Swap in your local Medicare rate.

  • 31540
    Laryngeal excision · 4.02 wRVU
    —
  • 31541
    Tumor excision · 4.41 wRVU
    —
  • 31535
    Laryngeal biopsy · 3.08 wRVU
    —
  • 31536
    Laryngeal biopsy · 3.46 wRVU
    —

How to choose

31541Tumor excision
Choose 31541 when an operating microscope or telescope is used for the tumor excision. This code describes the corresponding excision without that specified equipment.
31535Laryngeal biopsy
31535 is for direct operative laryngoscopy with biopsy. Report this code when the surgeon excises the tumor rather than taking a sample alone.
31536Laryngeal biopsy
31536 describes laryngoscopy with biopsy using an operating microscope or telescope. It is not the tumor-excision service reported here.

Codes related to 31540

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

Codes related to 31540
CodeHow it relatesNational office range
Same family
31541Tumor excisionTumor excision by direct operative laryngoscopy using an operating microscope or telescope.No office rate
Used instead
31535Laryngeal biopsyDirect operative laryngoscopy for biopsy when tissue is sampled rather than the tumor excised.No office rate
31536Laryngeal biopsyBiopsy version using an operating microscope or telescope.No office rate

31540 billing questions

How is this different from 31541?

Both codes describe direct operative laryngoscopy with tumor excision. Use 31541 when an operating microscope or telescope is used; this code is for the version without that specified equipment.

When should a biopsy code be used instead?

Use 31535 or 31536 when the laryngoscopy obtains a biopsy sample rather than excising the tumor. The operative note should make clear whether the surgeon sampled the lesion or removed it.

Can modifier 50 be reported for tumors on both sides?

No. CMS specifies that a bilateral adjustment does not apply and modifier 50 is inappropriate for this service.

Is same-day postoperative care included?

Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

What happens when another related endoscopy is performed in the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. The operative documentation should identify the procedures performed and the work for each.

Can an assistant, co-surgeon, or surgical team be paid?

Assistant-at-surgery payment is statutorily restricted for this code. CMS does not permit co-surgeons or team surgery.

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 31540PPRRVU2026_Oct_nonQPP.csv, line 3,592 (RVU26D)

Open CMS sourceHow we calculate rates

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