Billing code 31420: EpiglottidectomyMedicare rate & RVUs in Guam
Epiglottidectomy reports surgical removal of part or all of the epiglottis, such as for selected patients with epiglottic obstruction or collapse.
CMS doesn’t publish an office rate for 31420 in Guam.
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 31420 covers
An otolaryngologist removes part or all of the epiglottis to address disease involving this structure. A recognized setting is treatment of selected patients with obstructive sleep apnea associated with epiglottic collapse; epiglottidectomy may also be performed for other specific epiglottic disorders. The procedure is generally performed in an operating room, with the operative approach and extent guided by the condition and anatomy.
Report the code when the documented operation removes epiglottic tissue, rather than merely sampling a lesion or revising another part of the larynx. The operative report should identify the indication, the epiglottis treated, and the extent of removal. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
31420 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $761.73 |
How the 31420 rate is calculated
Each of 31420’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 · 31420
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.14Practice expense 9.43Malpractice 1.63
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31420
31420 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31420
Epiglottidectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 31420
Epiglottidectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
31420 without 51 · national facility
$741.50
Epiglottidectomy
31420-51 · Second procedure: 50%
$370.75
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%).
31420 compared with similar codes
Compare codes
31420 vs 31540 vs 31541 vs 31400: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31540Laryngeal excision
- This code describes epiglottidectomy. Choose 31540 for direct operative laryngoscopic excision or stripping of focal laryngeal tissue when that is the documented service.
- 31541Tumor excision
- This code reports epiglottidectomy; 31541 is for operative laryngoscopic excision or stripping performed with an operating microscope or telescope.
- 31400Larynx revision
- 31400 describes revision of the larynx. Use 31420 when the documented operation removes epiglottic tissue rather than revising the larynx.
31420 billing questions
When should this code be chosen over an operative laryngoscopy code?
Use 31420 when the operation removes part or all of the epiglottis. Codes for operative laryngoscopy may describe focal lesion excision or biopsy instead.
Is a diagnostic laryngoscopy separately reported during the same operation?
The operative report should support the work performed; do not treat an inspection that is part of the epiglottidectomy as a separate service.
Can modifier 50 be used for removal on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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
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