$810.82
Choose 31591 for framework medialization through the neck; choose 31574 for endoscopic injection augmentation.
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CMS RVU26D · Effective 2026-10-01
31591 Laryngoplasty Medicare reimbursement rates in Kentucky
Reports framework surgery that moves one vocal fold toward the midline, commonly to improve glottic closure in unilateral vocal fold paralysis. Compare 31591 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 31591 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
$939.41
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.
Laryngeal surgery
About 31591: Unilateral vocal fold medialization surgery
Reports framework surgery that moves one vocal fold toward the midline, commonly to improve glottic closure in unilateral vocal fold paralysis.
An otolaryngologist or laryngologist performs this framework procedure to move one vocal fold toward the midline and improve glottic closure. A typical indication is unilateral vocal fold paralysis or immobility causing a persistent voice or airway-protection problem. In a type I thyroplasty approach, the surgeon works through the neck and adjusts the thyroid cartilage framework, commonly placing an implant to medialize the fold. The procedure is generally performed in an operating room.
Report the code for unilateral medialization surgery, not for endoscopic injection augmentation or diagnostic examination alone. The operative report should identify the treated side, the indication, and the framework work performed. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery and co-surgeon payment require the documentation described in CMS rules; team surgery is not permitted.
CMS billing rules for 31591
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.22 · 44%
- Practice expense (office) RVU14.78 · 49%
- Malpractice RVU1.93 · 6%
1.1K
Medicare services in 2024 · #2878 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.
31591 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
31590 reports laryngeal reinnervation, which seeks to restore nerve input; 31591 mechanically medializes the vocal fold.
$116.66
31575 is diagnostic laryngoscopy. It does not represent the surgical framework work that supports 31591.
Compare 31591 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
$939.41
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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 31591 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
3,617
- Code
- 31591
- Physician work
- 13.22
- Practice expense
- 14.78
- Malpractice
- 1.93
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.22 | × 1.000 | 13.2200 |
| Practice expense | 14.78 | × 0.889 | 13.1394 |
| Malpractice | 1.93 | × 0.915 | 1.7659 |
| Total RVUs | 28.1254 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$939.41
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.22 | 1 |
| Practice expense | 14.78 | 0.889 |
| Malpractice | 1.93 | 0.915 |
(13.22 × 1 + 14.78 × 0.889 + 1.93 × 0.915) × $33.4009 = $939.41
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.
31591 billing questions
How does this differ from vocal fold injection augmentation?
This code describes framework surgery that medializes one vocal fold. Code 31574 is for endoscopic injection augmentation, a different method of addressing glottic insufficiency.
What documentation supports reporting this code?
Document the indication, the side treated, and the operative steps showing framework medialization. The record should distinguish the surgery from injection augmentation or a diagnostic laryngeal examination.
Can the procedure be reported bilaterally?
CMS lists bilateral payment with modifier 50 at 150%. The operative documentation should support treatment of both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant or co-surgeon paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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.
3,61431584,,Laryngoplasty fx rdctj fixj,A,,17.14,18.28,NA,18.28,,2.50,37.92,37.92,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,61531587,,Laryngoplasty cricoid split,A,,14.89,15.59,NA,15.59,,2.17,32.65,32.65,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,61631590,,Reinnervate larynx,A,,7.65,17.64,NA,17.64,,1.12,26.41,26.41,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,61731591,,Laryngoplasty medialization,A,,13.22,14.78,NA,14.78,,1.93,29.93,29.93,0,090,0.10,0.76,0.14,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,61831592,,Cricotracheal resection,A,,24.38,17.90,NA,17.90,,3.56,45.84,45.84,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,61931599,,Unlisted procedure larynx,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,62031600,,Planned tracheostomy,A,,5.42,1.69,NA,1.69,,1.07,8.18,8.18,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,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