No office rate
Both describe operative laryngeal biopsy; this code is distinguished by use of an operating telescope or microscope.
On this page
CMS RVU26D · Effective 2026-10-01
31536 Laryngeal biopsy Medicare reimbursement rates in Virginia
An otolaryngologist uses an operating scope during direct laryngoscopy to biopsy a laryngeal lesion, such as a suspicious vocal fold abnormality. Compare 31536 office and facility rates across CMS payment localities in Virginia.
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 31536 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$173.42–$195.50
2 of 2 localities have a supported rate.
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.
Laryngology procedure
About 31536: Operative laryngeal biopsy with scope
An otolaryngologist uses an operating scope during direct laryngoscopy to biopsy a laryngeal lesion, such as a suspicious vocal fold abnormality.
An otolaryngologist uses a direct laryngoscope with an operating telescope or microscope to inspect the larynx and take tissue from a lesion for examination. Common indications include a suspicious vocal fold or laryngeal mucosal abnormality, such as a persistent lesion requiring histologic diagnosis. The procedure is commonly performed in an operating room, often under general anesthesia; the specimen is sent for pathology review.
Report this code when the operative scope is used and tissue is sampled for biopsy, rather than when the primary service is diagnostic visualization alone or definitive lesion excision. The operative note should identify the laryngeal site, lesion, biopsy performed, and use of the scope. CMS assigns a 0-day global period, including same-day preoperative and postoperative care. Related endoscopies performed together are subject to endoscopy-family pricing. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 31536
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.46 · 65%
- Practice expense (office) RVU1.41 · 26%
- Malpractice RVU0.49 · 9%
6.6K
Medicare services in 2024 · #1700 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.
31536 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
31526 is for diagnostic direct laryngoscopy with an operating scope. This code includes biopsy of laryngeal tissue.
No office rate
Use 31541 when the operative service is laryngeal tumor excision with an operating scope; this code represents biopsy rather than excision.
Compare 31536 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$195.50
Virginia →
Office / nonfacility
Unavailable
Facility
$173.42
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31536 billing questions
When should this code be chosen instead of 31535?
Choose this code when the laryngeal biopsy is performed with an operating telescope or microscope. Code 31535 describes the related biopsy service without that scope distinction.
Does taking a biopsy include definitive removal of the lesion?
A biopsy samples tissue for diagnosis. When the operative service is excision of a laryngeal tumor or lesion rather than biopsy, consider the applicable excision code, such as 31541 when an operating scope is used.
Can modifier 50 be reported for biopsies on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.
What should the operative note document?
Document the laryngeal site and lesion, the tissue sampling, and use of the operating telescope or microscope. The record should make clear that the service was a biopsy rather than diagnostic inspection alone or definitive excision.
How does CMS handle other endoscopies performed in the same session?
When related endoscopies are performed together, CMS applies endoscopy-family pricing. Payment is not determined as though each related endoscopy were an independent procedure.
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.
3,58831530,,Laryngoscopy w/fb removal,A,,3.30,1.37,NA,1.37,,0.51,5.18,5.18,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,58931531,,Laryngoscopy w/fb & op scope,A,,3.49,1.45,NA,1.45,,0.50,5.44,5.44,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
3,59031535,,Laryngoscopy w/biopsy,A,,3.08,1.32,NA,1.32,,0.45,4.85,4.85,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,59131536,,Laryngoscopy w/bx & op scope,A,,3.46,1.41,NA,1.41,,0.49,5.36,5.36,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
3,59231540,,Laryngoscopy w/exc of tumor,A,,4.02,1.55,NA,1.55,,0.58,6.15,6.15,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31525,33.4009,09,0,99,0.00,0.00,0.00
3,59331541,,Larynscop w/tumr exc + scope,A,,4.41,1.64,NA,1.64,,0.64,6.69,6.69,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00
3,59431545,,Remove vc lesion w/scope,A,,6.14,2.11,NA,2.11,,0.90,9.15,9.15,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00