No office rate
Both include operative laryngoscopy with arytenoidectomy. The distinguishing feature for 31561 is use of an operating microscope or telescope.
On this page
CMS RVU26D · Effective 2026-10-01
31561 Arytenoidectomy Medicare reimbursement rates in Iowa
Reports operative direct laryngoscopy with arytenoid cartilage removal using an operating microscope or telescope, commonly to widen the laryngeal airway. Compare 31561 office and facility rates across CMS payment localities in Iowa.
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 31561 in Iowa?
Iowa 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
$265.32
1 of 1 localities have a supported rate.
Payment area: Iowa
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 surgery
About 31561: Direct laryngoscopy with arytenoidectomy
Reports operative direct laryngoscopy with arytenoid cartilage removal using an operating microscope or telescope, commonly to widen the laryngeal airway.
An otolaryngologist performs an operative direct examination of the larynx and removes arytenoid cartilage tissue while viewing through an operating microscope or telescope. The procedure is commonly used to enlarge the posterior glottic airway in patients with bilateral vocal-fold immobility or posterior glottic narrowing, and is typically performed in an operating room.
Report 31561 when an arytenoidectomy is performed with the specified optical equipment; the operative note should describe the indication, side and extent of removal, and use of the microscope or telescope. Choose 31560 for arytenoidectomy without that equipment. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. Do not append modifier 50. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 31561
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.84 · 68%
- Practice expense (office) RVU1.93 · 22%
- Malpractice RVU0.85 · 10%
156
Medicare services in 2024 · #4532 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.
31561 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
31535 is for operative laryngoscopy with biopsy. Use 31561 when arytenoid cartilage is removed with the specified optical equipment.
No office rate
31540 describes excision of a laryngeal tumor; 31561 describes arytenoidectomy. Select based on the operative target and service performed.
No office rate
31545 addresses removal of a vocal-cord lesion. It is not the code for removal of arytenoid cartilage.
Compare 31561 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
Iowa →
Office / nonfacility
Unavailable
Facility
$265.32
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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 31561 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,602
- Code
- 31561
- Physician work
- 5.84
- Practice expense
- 1.93
- Malpractice
- 0.85
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.84 | × 1.000 | 5.8400 |
| Practice expense | 1.93 | × 0.915 | 1.7659 |
| Malpractice | 0.85 | × 0.397 | 0.3375 |
| Total RVUs | 7.9434 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$265.32
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.84 | 1 |
| Practice expense | 1.93 | 0.915 |
| Malpractice | 0.85 | 0.397 |
(5.84 × 1 + 1.93 × 0.915 + 0.85 × 0.397) × $33.4009 = $265.32
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.
31561 billing questions
How does 31561 differ from 31560?
Both describe operative laryngoscopy with arytenoidectomy. Use 31561 when an operating microscope or telescope is used; 31560 describes the procedure without that equipment.
What documentation supports 31561?
The operative report should establish that arytenoid cartilage was removed and that an operating microscope or telescope was used. Include the indication and the side and extent of the procedure.
Can the laryngoscopic examination be billed separately?
The direct laryngoscopic view is how the arytenoidectomy is performed. When related endoscopies are performed together, CMS endoscopy-family pricing applies.
Should modifier 50 be reported for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not append modifier 50.
When is assistant-at-surgery payment available?
CMS allows assistant-at-surgery payment only when medical necessity is documented. 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.
3,59931554,,Laryngoplasty laryngeal sten,A,,21.45,20.35,NA,20.35,,3.12,44.92,44.92,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,6003155F,,Cytogen test marrow b/4 tx,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
3,60131560,,Laryngoscop w/arytenoidectom,A,,5.31,1.80,NA,1.80,,0.79,7.90,7.90,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,60231561,,Larynscop remve cart + scop,A,,5.84,1.93,NA,1.93,,0.85,8.62,8.62,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
3,60331570,,Laryngoscope w/vc inj,A,,3.76,5.95,,1.52,,0.60,10.31,5.88,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,60431571,,Laryngoscop w/vc inj + scope,A,,4.15,1.58,NA,1.58,,0.60,6.33,6.33,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
3,60531572,,Largsc w/laser dstrj les,A,,2.93,11.96,,1.28,,0.43,15.32,4.64,0,000,0.00,0.00,0.00,3,1,0,0,0,9,31575,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136