No office rate
Both describe direct operative laryngoscopy with biopsy. Choose 31536 when the documented procedure uses an operating microscope or telescope.
On this page
CMS RVU26D · Effective 2026-10-01
31535 Laryngeal biopsy Medicare reimbursement rates in Kentucky
Report direct operative laryngoscopy with biopsy when an otolaryngologist obtains tissue from a laryngeal lesion for diagnostic evaluation. Compare 31535 office and facility rates across CMS payment localities in Kentucky.
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 31535 in Kentucky?
Kentucky 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
$155.82
1 of 1 localities have a supported rate.
Payment area: Kentucky
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
About 31535: Direct operative laryngeal biopsy
Report direct operative laryngoscopy with biopsy when an otolaryngologist obtains tissue from a laryngeal lesion for diagnostic evaluation.
An otolaryngologist performs a direct operative examination of the larynx and takes a tissue sample from a lesion or abnormal area for diagnostic evaluation. The service is commonly performed in an operating room, often under anesthesia, when a lesion needs tissue diagnosis. Examples include sampling a suspicious vocal fold or other laryngeal lesion; the code reflects biopsy, not complete removal of the lesion.
Select this code when the operative service includes direct laryngoscopy and tissue sampling. The operative report should identify the laryngeal site, describe the lesion and approach, and document that tissue was obtained. CMS assigns a zero-day global period, so same-day preoperative and postoperative care is included. Endoscopy-family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 31535
- 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 RVU3.08 · 64%
- Practice expense (office) RVU1.32 · 27%
- Malpractice RVU0.45 · 9%
4.9K
Medicare services in 2024 · #1877 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.
31535 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
31535 reports biopsy sampling for diagnosis; 31540 applies when the operative service excises a laryngeal lesion or tumor.
$233.12
31525 is direct diagnostic laryngoscopy without tissue sampling. Report 31535 when a biopsy is obtained during the operative examination.
$198.38
31510 describes biopsy by indirect laryngoscopy. 31535 is for the direct operative approach.
Compare 31535 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$155.82
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 31535 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
3,590
- Code
- 31535
- Physician work
- 3.08
- Practice expense
- 1.32
- Malpractice
- 0.45
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.08 | × 1.000 | 3.0800 |
| Practice expense | 1.32 | × 0.889 | 1.1735 |
| Malpractice | 0.45 | × 0.915 | 0.4118 |
| Total RVUs | 4.6652 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$155.82
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.08 | 1 |
| Practice expense | 1.32 | 0.889 |
| Malpractice | 0.45 | 0.915 |
(3.08 × 1 + 1.32 × 0.889 + 0.45 × 0.915) × $33.4009 = $155.82
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.
31535 billing questions
When should 31535 be chosen over 31536?
Use 31535 for direct operative laryngoscopy with biopsy without the operating microscope or telescope distinction. Use 31536 when the documented procedure includes an operating microscope or telescope.
How does a biopsy differ from laryngeal lesion excision?
31535 describes taking tissue for diagnosis. When the operative service removes or excises the lesion rather than sampling it, consider 31540 or the applicable related excision code.
Can diagnostic laryngoscopy be billed separately with the biopsy?
The direct examination is part of the operative laryngoscopy with biopsy. Do not separately report a diagnostic laryngoscopy for the same examination.
How should related endoscopies performed in the same session be handled?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The operative record should support each distinct service reported.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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.
3,58731529,,Laryngoscopy and dilation,A,,2.61,1.14,NA,1.14,,0.38,4.13,4.13,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,58831530,,Laryngoscopy w/fb removal,A,,3.30,1.37,NA,1.37,,0.51,5.18,5.18,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,58931531,,Laryngoscopy w/fb & op scope,A,,3.49,1.45,NA,1.45,,0.50,5.44,5.44,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
3,59031535,,Laryngoscopy w/biopsy,A,,3.08,1.32,NA,1.32,,0.45,4.85,4.85,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,59131536,,Laryngoscopy w/bx & op scope,A,,3.46,1.41,NA,1.41,,0.49,5.36,5.36,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
3,59231540,,Laryngoscopy w/exc of tumor,A,,4.02,1.55,NA,1.55,,0.58,6.15,6.15,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,59331541,,Larynscop w/tumr exc + scope,A,,4.41,1.64,NA,1.64,,0.64,6.69,6.69,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631