No office rate
31300 concerns removal of a laryngeal lesion. Use 31395 only when the operative service includes reconstruction involving the larynx and pharynx.
On this page
CMS RVU26D · Effective 2026-10-01
31395 Airway reconstruction Medicare reimbursement rates in Guam
Reports major operative reconstruction involving the larynx and pharynx, typically to restore anatomy after a substantial head-and-neck defect. Compare 31395 office and facility rates across CMS payment localities in Guam.
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 31395 in Guam?
Guam 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
No supported rate
Facility setting
$2592.35
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Head and neck surgery
About 31395: Laryngeal and pharyngeal reconstruction
Reports major operative reconstruction involving the larynx and pharynx, typically to restore anatomy after a substantial head-and-neck defect.
This code represents major reconstruction of laryngeal and pharyngeal structures, rather than removal of a laryngeal lesion alone. An otolaryngologist or head-and-neck surgeon typically performs the operation in a hospital operating room, often when a substantial defect requires restoration of these connected structures. The operative report should make clear what anatomy was reconstructed and describe the reconstructive work performed.
Select the code based on the documented reconstruction, not simply because a laryngeal or pharyngeal resection occurred. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 31395
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU42.71 · 56%
- Practice expense (office) RVU27.52 · 36%
- Malpractice RVU6.24 · 8%
29
Medicare services in 2024 · #5683 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.
31395 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
31360 is a laryngeal removal procedure. This code instead represents reconstructive work involving both the larynx and pharynx.
No office rate
31390 describes removal involving the larynx and pharynx. The distinguishing work for 31395 is reconstruction, not extirpation alone.
Compare 31395 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$2592.35
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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 31395 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,567
- Code
- 31395
- Physician work
- 42.71
- Practice expense
- 27.52
- Malpractice
- 6.24
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 42.71 | × 1.000 | 42.7100 |
| Practice expense | 27.52 | × 1.137 | 31.2902 |
| Malpractice | 6.24 | × 0.579 | 3.6130 |
| Total RVUs | 77.6132 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$2592.35
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 42.71 | 1 |
| Practice expense | 27.52 | 1.137 |
| Malpractice | 6.24 | 0.579 |
(42.71 × 1 + 27.52 × 1.137 + 6.24 × 0.579) × $33.4009 = $2592.35
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.
31395 billing questions
How does this differ from a laryngectomy code?
This code describes reconstructive work involving the larynx and pharynx. Laryngectomy codes describe removal of laryngeal structures; the operative report must support the reconstruction for this code.
Does removal of a lesion support this code?
Not by itself. A laryngeal lesion removal, such as the service represented by 31300, is different from reconstruction involving the larynx and pharynx.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures performed in that session.
What documentation supports reporting this code?
The operative report should identify the laryngeal and pharyngeal anatomy reconstructed and describe the reconstructive work. It should distinguish that work from resection alone.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is 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.
3,56431380,,Partial removal of larynx,A,,24.93,22.44,NA,22.44,,3.63,51.00,51.00,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56531382,,Partial removal of larynx,A,,27.86,23.71,NA,23.71,,4.06,55.63,55.63,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56631390,,Removal of larynx & pharynx,A,,41.45,25.28,NA,25.28,,6.05,72.78,72.78,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56731395,,Reconstruct larynx & pharynx,A,,42.71,27.52,NA,27.52,,6.24,76.47,76.47,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56831400,,Revision of larynx,A,,11.31,15.00,NA,15.00,,1.65,27.96,27.96,0,090,0.10,0.76,0.14,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,5693140F,,Upper gi endo shows barrtts,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,5703141F,,Upper gi endo not barrtts,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014