No office rate
This code covers removal of both the larynx and pharynx. Code 31360 is for total laryngectomy without the pharyngeal resection.
On this page
CMS RVU26D · Effective 2026-10-01
31390 Laryngopharyngectomy Medicare reimbursement rates in Vermont
Reports removal of the larynx and pharynx, typically for an advanced disease process involving both structures and requiring a major ablative operation. Compare 31390 office and facility rates across CMS payment localities in Vermont.
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 31390 in Vermont?
Vermont 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
$2322.65
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Head and neck surgery
About 31390: Total laryngopharyngectomy
Reports removal of the larynx and pharynx, typically for an advanced disease process involving both structures and requiring a major ablative operation.
This code describes an operation removing the larynx and pharynx, generally performed by an otolaryngologist or head and neck surgeon for disease involving both structures, such as an extensive malignancy. The procedure is typically done in a hospital operating room and may be followed by reconstruction to restore continuity or support swallowing. The operative report should identify the structures removed and the extent of the resection.
Report the code when the documented operation includes removal of both the larynx and pharynx; a larynx-only resection or removal of a limited laryngeal lesion is different. The service has a 90-day global period, including 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 other procedures are subject to the standard 50% multiple-procedure reduction. Do not use modifier 50. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 31390
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU41.45 · 57%
- Practice expense (office) RVU25.28 · 35%
- Malpractice RVU6.05 · 8%
34
Medicare services in 2024 · #5580 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.
31390 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Code 31365 describes total laryngectomy with radical neck dissection; use this code when the operative resection also removes the pharynx.
No office rate
Code 31300 is for removal of a laryngeal lesion, not an operation removing the larynx and pharynx.
No office rate
This code reports the ablative removal of the larynx and pharynx. Code 31395 concerns reconstruction of those structures.
Compare 31390 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
Vermont →
Office / nonfacility
Unavailable
Facility
$2322.65
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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 31390 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,566
- Code
- 31390
- Physician work
- 41.45
- Practice expense
- 25.28
- Malpractice
- 6.05
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 41.45 | × 1.000 | 41.4500 |
| Practice expense | 25.28 | × 0.990 | 25.0272 |
| Malpractice | 6.05 | × 0.506 | 3.0613 |
| Total RVUs | 69.5385 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$2322.65
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 41.45 | 1 |
| Practice expense | 25.28 | 0.99 |
| Malpractice | 6.05 | 0.506 |
(41.45 × 1 + 25.28 × 0.99 + 6.05 × 0.506) × $33.4009 = $2322.65
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.
31390 billing questions
How is this distinguished from a total laryngectomy?
Use this code when the operation removes both the larynx and pharynx. A total laryngectomy without pharyngeal removal is represented by a different code.
Can modifier 50 be used for bilateral work?
No. The CMS bilateral adjustment does not apply to this code; the descriptor or anatomy makes modifier 50 inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
What documentation supports this code?
The operative report should establish that both the larynx and pharynx were removed and describe the resection performed.
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.
3,56331375,,Partial removal of larynx,A,,25.42,22.56,NA,22.56,,3.70,51.68,51.68,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56431380,,Partial removal of larynx,A,,24.93,22.44,NA,22.44,,3.63,51.00,51.00,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56531382,,Partial removal of larynx,A,,27.86,23.71,NA,23.71,,4.06,55.63,55.63,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56631390,,Removal of larynx & pharynx,A,,41.45,25.28,NA,25.28,,6.05,72.78,72.78,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56731395,,Reconstruct larynx & pharynx,A,,42.71,27.52,NA,27.52,,6.24,76.47,76.47,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,56831400,,Revision of larynx,A,,11.31,15.00,NA,15.00,,1.65,27.96,27.96,0,090,0.10,0.76,0.14,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,5693140F,,Upper gi endo shows barrtts,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817