CPT code 31546: Vocal fold excision2026 Medicare rate & RVUs in Oklahoma
Direct laryngoscopic removal of a vocal-fold lesion with microscope or telescope guidance and graft placement, reported when both excision and grafting are performed.
CMS doesn’t publish an office rate for 31546 in Oklahoma.
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 31546 covers
This operative service removes a vocal-fold lesion through direct laryngoscopy, using an operating microscope or telescope, and includes placement of a graft. An otolaryngologist typically performs it in an operating room when lesion excision and graft placement are planned in the same operation. The graft is the key distinction from the related vocal-fold lesion excision without graft placement.
Report the service when the operative documentation supports lesion excision and graft placement; biopsy alone, injection, or laser destruction describes a different service. 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. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; 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.
31546 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $439.92 |
How the 31546 rate is calculated
Each of 31546’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 · 31546
RVUs × geographic indexes × conversion factor
Work9.49
9.49 RVUs× 1.000 GPCI
Practice expense2.93
2.93 RVUs× 1.000 GPCI
Malpractice1.37
1.37 RVUs× 1.000 GPCI
Adjusted RVUs
13.7900
Conversion factor
$33.4009
Medicare rate
$460.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31546
The CMS indicators that decide how 31546 is paid alongside other services.
CMS payment indicators · 31546
Vocal fold excision
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 50 · payment effect
With and without the modifier
31546 without 50 · national facility
$460.60
Vocal fold excision
31546-50 · Bilateral: 150%
$690.90
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
31546 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31545Vocal cord excision
- Both address vocal-fold lesion excision with microscope or telescope guidance; 31546 is distinguished by graft placement.
- 31541Tumor excision
- 31541 is used for operative excision of a tumor or vocal-cord stripping with microscope or telescope guidance; 31546 describes lesion excision with graft placement.
- 31535Laryngeal biopsy
- 31535 describes laryngoscopic biopsy for tissue sampling. Choose 31546 when the documented operation includes lesion excision and graft placement.
- 31572Laser laryngoscopy
- 31572 treats a lesion by laryngoscopic laser destruction; 31546 involves excision and graft placement.
31546 billing questions
When should I choose this code over 31545?
Use 31546 when the vocal-fold lesion is excised and a graft is placed. The related 31545 service is the excision without graft placement.
Does this code include graft placement?
Yes. Graft placement is part of the service described by this code and is what distinguishes it from the related excision code without a graft.
Can I report a biopsy or laser treatment as this service?
No. A biopsy without definitive excision, or laser destruction without excision and graft placement, describes a different service.
How should a bilateral procedure be reported?
CMS identifies this as a bilateral procedure. Modifier 50 is paid at 150%.
How are related endoscopies priced when performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together.
Can an assistant or co-surgeon be paid for this operation?
Assistant-at-surgery payment is subject to a statutory restriction. 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 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
Show the CMS file lines behind this rate
Fee sheets
Put 31546 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →