$135.88
31575 covers flexible laryngeal examination without tissue sampling. Report 31576 when a biopsy is performed during the flexible examination.
On this page
CMS RVU26D · Effective 2026-10-01
31576 Laryngeal biopsy Medicare reimbursement rates in Connecticut
An otolaryngologist uses a flexible scope to inspect the larynx and obtain tissue from a suspicious area for diagnostic evaluation. Compare 31576 office and facility rates across CMS payment localities in Connecticut.
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 31576 in Connecticut?
Connecticut 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
$286.87
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$109.53
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 procedure
About 31576: Flexible laryngoscopy with biopsy
An otolaryngologist uses a flexible scope to inspect the larynx and obtain tissue from a suspicious area for diagnostic evaluation.
This service involves passing a flexible endoscope to examine the larynx and taking one or more tissue samples from an abnormal area. Otolaryngologists commonly perform it in an office or facility when a vocal fold or other laryngeal finding needs tissue diagnosis. The scope provides visualization and access for the biopsy; the purpose is sampling, not removing a lesion as treatment.
Report the service when the flexible examination includes an actual tissue biopsy, and document the sampled site, endoscopic findings, and biopsy performed. Same-day preoperative and postoperative care is included in the 0-day global period. When related endoscopies are performed together, endoscopy family pricing applies. A bilateral adjustment is not appropriate. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted for this service.
CMS billing rules for 31576
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.84 · 23%
- Practice expense (office) RVU5.94 · 74%
- Malpractice RVU0.26 · 3%
666
Medicare services in 2024 · #3308 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.
31576 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$324.80
31578 is for flexible endoscopic removal of a lesion. Choose 31576 when tissue is sampled for diagnosis rather than the lesion being removed as treatment.
No office rate
31535 describes biopsy using direct laryngoscopy. 31576 is the flexible endoscopic approach.
$207.66
31579 involves stroboscopic examination of laryngeal function. 31576 is distinguished by obtaining tissue for biopsy.
Compare 31576 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
Connecticut →
Office / nonfacility
$286.87
Facility
$109.53
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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 31576 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
3,609
- Code
- 31576
- Physician work
- 1.84
- Practice expense
- 5.94
- Malpractice
- 0.26
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.84 | × 1.020 | 1.8768 |
| Practice expense | 5.94 | × 1.077 | 6.3974 |
| Malpractice | 0.26 | × 1.210 | 0.3146 |
| Total RVUs | 8.5888 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$286.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.84 | 1.02 |
| Practice expense | 5.94 | 1.077 |
| Malpractice | 0.26 | 1.21 |
(1.84 × 1.02 + 5.94 × 1.077 + 0.26 × 1.21) × $33.4009 = $286.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.84 | 1.02 |
| Practice expense | 1.01 | 1.077 |
| Malpractice | 0.26 | 1.21 |
(1.84 × 1.02 + 1.01 × 1.077 + 0.26 × 1.21) × $33.4009 = $109.53
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.
31576 billing questions
How does this differ from diagnostic flexible laryngoscopy?
This code includes tissue sampling during the flexible examination. Use diagnostic flexible laryngoscopy when the examination is performed without a biopsy.
When would a laryngoscopy code for lesion removal be more appropriate?
Use the removal service when the lesion is excised or otherwise removed as treatment. This code represents biopsy sampling for diagnosis, not therapeutic lesion removal.
What documentation supports reporting this service?
Document the laryngeal site examined, the abnormal finding, and that tissue was obtained with the flexible scope. The record should distinguish biopsy sampling from inspection alone or lesion removal.
Can modifier 50 be used for biopsies on both sides?
No. The CMS bilateral adjustment does not apply to this service, and modifier 50 is inappropriate.
How does payment work when related endoscopies are performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together. The code also has a 0-day global period, so same-day preoperative and postoperative care is included.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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 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.
3,60631573,,Largsc w/ther injection,A,,2.37,5.87,,1.13,,0.36,8.60,3.86,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
3,60731574,,Largsc w/njx augmentation,A,,2.37,24.27,,1.14,,0.36,27.00,3.87,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
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
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808