Billing code 31536: Laryngeal biopsyMedicare rate & RVUs in Guam
An otolaryngologist uses an operating scope during direct laryngoscopy to biopsy a laryngeal lesion, such as a suspicious vocal fold abnormality.
CMS doesn’t publish an office rate for 31536 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 31536 covers
An otolaryngologist uses a direct laryngoscope with an operating telescope or microscope to inspect the larynx and take tissue from a lesion for examination. Common indications include a suspicious vocal fold or laryngeal mucosal abnormality, such as a persistent lesion requiring histologic diagnosis. The procedure is commonly performed in an operating room, often under general anesthesia; the specimen is sent for pathology review.
Report this code when the operative scope is used and tissue is sampled for biopsy, rather than when the primary service is diagnostic visualization alone or definitive lesion excision. The operative note should identify the laryngeal site, lesion, biopsy performed, and use of the scope. CMS assigns a 0-day global period, including same-day preoperative and postoperative care. Related endoscopies performed together are subject to endoscopy-family pricing. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and 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.
31536 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $178.59 |
How the 31536 rate is calculated
Each of 31536’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 · 31536
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.46Practice expense 1.41Malpractice 0.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 31536
The CMS indicators that decide how 31536 is paid alongside other services.
CMS payment indicators · 31536
Laryngeal biopsy
| 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
31536 without 51 · national facility
$179.03
Laryngeal biopsy
31536-51 · Second procedure: 50%
$89.52
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%).
31536 compared with similar codes
Compare codes
31536 vs 31535 vs 31526 vs 31541: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 31535Laryngeal biopsy
- Both describe operative laryngeal biopsy; this code is distinguished by use of an operating telescope or microscope.
- 31526Diagnostic laryngoscopy
- 31526 is for diagnostic direct laryngoscopy with an operating scope. This code includes biopsy of laryngeal tissue.
- 31541Tumor excision
- Use 31541 when the operative service is laryngeal tumor excision with an operating scope; this code represents biopsy rather than excision.
31536 billing questions
When should this code be chosen instead of 31535?
Choose this code when the laryngeal biopsy is performed with an operating telescope or microscope. Code 31535 describes the related biopsy service without that scope distinction.
Does taking a biopsy include definitive removal of the lesion?
A biopsy samples tissue for diagnosis. When the operative service is excision of a laryngeal tumor or lesion rather than biopsy, consider the applicable excision code, such as 31541 when an operating scope is used.
Can modifier 50 be reported for biopsies on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.
What should the operative note document?
Document the laryngeal site and lesion, the tissue sampling, and use of the operating telescope or microscope. The record should make clear that the service was a biopsy rather than diagnostic inspection alone or definitive excision.
How does CMS handle other endoscopies performed in the same session?
When related endoscopies are performed together, CMS applies endoscopy-family pricing. Payment is not determined as though each related endoscopy were an independent procedure.
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
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