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CMS RVU26D · Effective 2026-10-01

31513 Vocal-fold injection Medicare reimbursement rates in Missouri

Reports therapeutic injection into a vocal fold under indirect laryngoscopic visualization, commonly to improve glottic closure in vocal-fold paralysis or atrophy. Compare 31513 office and facility rates across CMS payment localities in Missouri.

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 31513 in Missouri?

Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$108.43–$111.88

3 of 3 localities have a supported rate.

Lowest: Rest Of Missouri

Highest: Metropolitan St. Louis

A spread of $3.45 per service.

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.

Find 31513 in your payment locality →

Where 31513 pays more and less in Missouri

Otolaryngology

About 31513: Indirect laryngoscopy with vocal-fold injection

Reports therapeutic injection into a vocal fold under indirect laryngoscopic visualization, commonly to improve glottic closure in vocal-fold paralysis or atrophy.

An otolaryngologist uses indirect laryngoscopic visualization while injecting material into a vocal fold to improve closure and voice function. Common clinical reasons include vocal-fold paralysis or atrophy causing glottic insufficiency. The service may be performed in an office or facility; the record should identify the indication, injection site and approach, and the material used when known.

Select this code when the therapeutic injection is performed with an indirect approach, rather than direct laryngoscopy. Document the treatment and visualization performed; diagnostic visualization alone does not support the injection service. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this code. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.

CMS billing rules for 31513

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 RVU2.05 · 60%
  • Practice expense (office) RVU1.06 · 31%
  • Malpractice RVU0.29 · 9%

104

Medicare services in 2024 · #4850 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.

31513 compared with similar codes

Office rates for Missouri, from the same CMS release.

31505

Laryngoscopy

Indirect, diagnostic

$79.28–$85.33

31505 is for diagnostic indirect laryngoscopy. Choose 31513 when therapeutic vocal-fold injection is performed.

31570

Vocal fold injection

Direct, without optical magnification

$316.42–$334.86

31570 uses direct laryngoscopy for therapeutic injection; 31513 is the indirect approach.

31571

Vocal fold injection

Microscope or telescope

No office rate

31571 is a direct laryngoscopic injection performed with an operating microscope or telescope; 31513 describes the indirect approach.

Compare 31513 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.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

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31513 billing questions

When should this code be chosen instead of 31570?

Use 31513 for vocal-fold injection performed with indirect laryngoscopy. Code 31570 describes injection performed using direct laryngoscopy.

Does bilateral injection require modifier 50?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for its descriptor or anatomy.

What documentation supports reporting the injection?

Document the clinical reason for treatment, the vocal-fold site, the injection performed, and the indirect laryngoscopic visualization and approach.

Can a related endoscopy be separately reported at the same session?

When related endoscopies are performed together, CMS endoscopy family pricing applies. Report the services performed, with documentation supporting each service.

Is same-day preoperative or postoperative care separately included?

The 0-day global period includes same-day preoperative and postoperative care in the procedure.

What applies if an assistant or another surgeon participates?

Assistant-at-surgery payment requires documentation of medical necessity. 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.

RVUs for 31513PPRRVU2026_Oct_nonQPP.csv, line 3,580 (RVU26D)