Billing code 31591: LaryngoplastyMedicare rate & RVUs in Oklahoma
Reports framework surgery that moves one vocal fold toward the midline, commonly to improve glottic closure in unilateral vocal fold paralysis.
CMS doesn’t publish an office rate for 31591 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 31591 covers
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.
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 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $932.49 |
How the 31591 rate is calculated
Each of 31591’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 · 31591
RVUs × geographic indexes × conversion factor
Work13.22
13.22 RVUs× 1.000 GPCI
Practice expense14.78
14.78 RVUs× 1.000 GPCI
Malpractice1.93
1.93 RVUs× 1.000 GPCI
Adjusted RVUs
29.9300
Conversion factor
$33.4009
Medicare rate
$999.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31591
31591 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31591
Laryngoplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 31591
Laryngoplasty
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
31591 without 50 · national facility
$999.69
Laryngoplasty
31591-50 · Bilateral: 150%
$1,499.54
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).
31591 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31574Vocal fold injection
- Choose 31591 for framework medialization through the neck; choose 31574 for endoscopic injection augmentation.
- 31590Laryngeal reinnervation
- 31590 reports laryngeal reinnervation, which seeks to restore nerve input; 31591 mechanically medializes the vocal fold.
- 31575Laryngoscopy
- 31575 is diagnostic laryngoscopy. It does not represent the surgical framework work that supports 31591.
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 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
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