Billing code 31365: LaryngectomyMedicare rate & RVUs in Texas
Total removal of the larynx combined with radical neck dissection, typically reported for advanced laryngeal malignancy when both procedures are performed in one operation.
CMS doesn’t publish an office rate for 31365 in Texas.
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 31365 covers
This operation removes the entire larynx and includes a radical neck dissection to remove cervical lymphatic tissue. Head and neck surgeons, commonly otolaryngologists, perform it in a hospital or other surgical facility, often for advanced laryngeal cancer. A permanent neck stoma provides the airway after the larynx is removed.
Report 31365 when the operative record supports both complete laryngeal removal and radical neck dissection in the same operation; total laryngectomy without that dissection is a different service. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Do not append modifier 50 for a bilateral adjustment. An assistant at surgery may be paid; co-surgeons require supporting documentation, and 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.
Where 31365 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $2,241.22 |
| Beaumont | Unavailable | $2,134.06 |
| Brazoria | Unavailable | $2,177.59 |
| Dallas | Unavailable | $2,197.49 |
| Fort Worth | Unavailable | $2,192.34 |
| Galveston | Unavailable | $2,188.24 |
| Houston | Unavailable | $2,292.38 |
| Rest Of Texas | Unavailable | $2,158.84 |
How the 31365 rate is calculated
Each of 31365’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 · 31365
RVUs × geographic indexes × conversion factor
Work37.84
37.84 RVUs× 1.000 GPCI
Practice expense22.82
22.82 RVUs× 1.000 GPCI
Malpractice5.69
5.69 RVUs× 1.000 GPCI
Adjusted RVUs
66.3500
Conversion factor
$33.4009
Medicare rate
$2,216.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31365
31365 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 31365
Laryngectomy
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 31365
Laryngectomy
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 51 · payment effect
With and without the modifier
31365 without 51 · national facility
$2,216.15
Laryngectomy
31365-51 · Second procedure: 50%
$1,108.08
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
31365 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31360Laryngectomy
- Both involve total laryngeal removal; 31365 includes radical neck dissection, while 31360 describes total removal without it.
- 31367Partial laryngectomy
- 31367 represents partial laryngeal removal. Choose 31365 when the operation removes the entire larynx and includes radical neck dissection.
- 31390Laryngopharyngectomy
- 31390 is associated with removal involving both the larynx and pharynx. 31365 covers total laryngeal removal with radical neck dissection.
31365 billing questions
How does 31365 differ from 31360?
31365 includes total laryngectomy with radical neck dissection. Use 31360 for total laryngectomy without radical neck dissection.
Can the neck dissection be billed separately?
The radical neck dissection is included in 31365. Do not separately report another code for that same dissection.
Should modifier 50 be used for bilateral neck work?
No. CMS identifies bilateral adjustment as inappropriate for 31365; do not append modifier 50.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What documentation supports 31365?
The operative report should establish complete removal of the larynx and performance of a radical neck dissection in the same session.
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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