No office rate
Choose 31541 when an operating microscope or telescope is used for the tumor excision. This code describes the corresponding excision without that specified equipment.
On this page
CMS RVU26D · Effective 2026-10-01
31540 Laryngeal excision Medicare reimbursement rates in Virginia
Reports direct operative laryngoscopy to excise a laryngeal tumor, such as a mass on a vocal cord or epiglottis, during a surgical encounter. Compare 31540 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 31540 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
$198.84–$224.07
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 31540: Direct laryngeal tumor excision
Reports direct operative laryngoscopy to excise a laryngeal tumor, such as a mass on a vocal cord or epiglottis, during a surgical encounter.
An otolaryngologist performs this direct operative laryngoscopy to reach and excise a tumor in the larynx. The procedure is commonly performed in a facility operating room, with the patient under anesthesia. The surgeon may remove a visible mass from a vocal cord or epiglottis and submit the excised tissue for examination. The code distinguishes tumor excision from a laryngoscopy performed only to obtain a biopsy.
Report the service when the operative record supports excision of a laryngeal tumor, rather than sampling alone. Document the lesion’s location, the direct laryngoscopic approach, and the work performed; use the related code for the operating-microscope or telescope version when that technique is documented. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. CMS does not apply a bilateral adjustment, and modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 31540
- 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 RVU4.02 · 65%
- Practice expense (office) RVU1.55 · 25%
- Malpractice RVU0.58 · 9%
453
Medicare services in 2024 · #3651 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.
31540 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
31535 is for direct operative laryngoscopy with biopsy. Report this code when the surgeon excises the tumor rather than taking a sample alone.
No office rate
31536 describes laryngoscopy with biopsy using an operating microscope or telescope. It is not the tumor-excision service reported here.
Compare 31540 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
$224.07
Virginia →
Office / nonfacility
Unavailable
Facility
$198.84
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31540 billing questions
How is this different from 31541?
Both codes describe direct operative laryngoscopy with tumor excision. Use 31541 when an operating microscope or telescope is used; this code is for the version without that specified equipment.
When should a biopsy code be used instead?
Use 31535 or 31536 when the laryngoscopy obtains a biopsy sample rather than excising the tumor. The operative note should make clear whether the surgeon sampled the lesion or removed it.
Can modifier 50 be reported for tumors on both sides?
No. CMS specifies that a bilateral adjustment does not apply and modifier 50 is inappropriate for this service.
Is same-day postoperative care included?
Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
What happens when another related endoscopy is performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The operative documentation should identify the procedures performed and the work for each.
Can an assistant, co-surgeon, or surgical team be paid?
Assistant-at-surgery payment is statutorily restricted for this code. CMS does not permit co-surgeons or team surgery.
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.
3,58931531,,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
3,59531546,,Remove vc lesion scope/graft,A,,9.49,2.93,NA,2.93,,1.37,13.79,13.79,0,000,0.00,0.00,0.00,3,1,1,0,0,9,31526,33.4009,09,0,99,0.00,0.00,0.00