Billing code 31540: Laryngeal excisionMedicare rate & RVUs in Alaska
Reports direct operative laryngoscopy to excise a laryngeal tumor, such as a mass on a vocal cord or epiglottis, during a surgical encounter.
CMS doesn’t publish an office rate for 31540 in Alaska.
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 9 sections
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.
31540 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $267.22 |
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
Work4.02
4.02 RVUs× 1.000 GPCI
Practice expense1.55
1.55 RVUs× 1.000 GPCI
Malpractice0.58
0.58 RVUs× 1.000 GPCI
Adjusted RVUs
6.1500
Conversion factor
$33.4009
Medicare rate
$205.42
Every GPCI starts 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
| 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
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%).
31540 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
Fee sheets
Put 31540 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 →