$239.97
31576 is for flexible laryngoscopy with tissue sampling for biopsy. Choose 31578 when the physician removes the lesion rather than merely sampling it.
On this page
CMS RVU26D · Effective 2026-10-01
31578 Laryngoscopy Medicare reimbursement rates in Alabama
Reports flexible endoscopic removal of a laryngeal lesion, such as a vocal fold lesion, when the physician physically removes it through the scope. Compare 31578 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 31578 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$272.43
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$119.28
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Otolaryngology
About 31578: Flexible laryngoscopic lesion removal
Reports flexible endoscopic removal of a laryngeal lesion, such as a vocal fold lesion, when the physician physically removes it through the scope.
An otolaryngologist typically performs this procedure using a flexible laryngoscope to visualize the larynx and remove a lesion through the scope. It may be performed in an office or facility when the lesion can be reached and treated with the flexible endoscopic approach. The service involves removal, not simply inspection or tissue sampling; the operative note should identify the lesion, its laryngeal location, the removal technique, and the result.
Report this code when the physician removes a lesion using flexible laryngoscopy; use a biopsy, laser-treatment, or foreign-body code when that is the service performed instead. Documentation should support the therapeutic work rather than diagnostic visualization alone. CMS assigns 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. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 31578
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.37 · 26%
- Practice expense (office) RVU6.38 · 70%
- Malpractice RVU0.36 · 4%
26
Medicare services in 2024 · #5752 by national volume
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.
31578 compared with similar codes
Office rates for Alabama, from the same CMS release.
$455.53
31572 describes laser destruction or ablation of a lesion. This code is for physical lesion removal through flexible laryngoscopy.
No office rate
31545 is an operative direct-laryngoscopy approach for vocal-cord lesion removal. This code describes removal with a flexible scope.
$249.46
31577 is for removal of a foreign body from the larynx using flexible laryngoscopy, not removal of a laryngeal lesion.
Compare 31578 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$272.43
Facility
$119.28
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 31578 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
3,611
- Code
- 31578
- Physician work
- 2.37
- Practice expense
- 6.38
- Malpractice
- 0.36
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.37 | × 1.000 | 2.3700 |
| Practice expense | 6.38 | × 0.875 | 5.5825 |
| Malpractice | 0.36 | × 0.566 | 0.2038 |
| Total RVUs | 8.1563 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$272.43
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.37 | 1 |
| Practice expense | 6.38 | 0.875 |
| Malpractice | 0.36 | 0.566 |
(2.37 × 1 + 6.38 × 0.875 + 0.36 × 0.566) × $33.4009 = $272.43
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.37 | 1 |
| Practice expense | 1.14 | 0.875 |
| Malpractice | 0.36 | 0.566 |
(2.37 × 1 + 1.14 × 0.875 + 0.36 × 0.566) × $33.4009 = $119.28
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
31578 billing questions
How does this differ from flexible laryngoscopy with biopsy?
Use 31578 when the lesion is removed. Use 31576 when the physician obtains tissue for biopsy rather than removing the lesion as the therapeutic service.
Can diagnostic laryngoscopy be reported separately?
The visualization is part of the lesion-removal service. Do not separately report diagnostic laryngoscopy for the same examination.
When is the laser lesion code a better fit?
Use 31572 when the lesion is destroyed or ablated with a laser. This code describes physical removal through flexible laryngoscopy.
Should modifier 50 be appended for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What should the operative note describe?
Document the lesion's laryngeal location, the flexible endoscopic approach, how the lesion was removed, and the outcome. The record should distinguish removal from biopsy, laser destruction, or foreign-body extraction.
How are related endoscopies handled when performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The code has a 0-day global period, including same-day preoperative and postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,60831575,,Diagnostic laryngoscopy,A,,0.92,2.76,,0.78,,0.13,3.81,1.83,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,60931576,,Laryngoscopy with biopsy,A,,1.84,5.94,,1.01,,0.26,8.04,3.11,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
3,61031577,,Largsc w/rmvl foreign bdy(s),A,,2.14,5.87,,1.08,,0.34,8.35,3.56,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
3,61131578,,Largsc w/removal lesion,A,,2.37,6.38,,1.14,,0.36,9.11,3.87,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
3,61231579,,Laryngoscopy telescopic,A,,1.83,3.77,,1.04,,0.24,5.84,3.11,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
3,61331580,,Laryngoplasty laryngeal web,A,,14.24,18.58,NA,18.58,,2.08,34.90,34.90,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,61431584,,Laryngoplasty fx rdctj fixj,A,,17.14,18.28,NA,18.28,,2.50,37.92,37.92,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515