No office rate
Both address vocal-fold lesion excision with microscope or telescope guidance; 31546 is distinguished by graft placement.
On this page
CMS RVU26D · Effective 2026-10-01
31546 Vocal fold excision Medicare reimbursement rates in Wyoming
Direct laryngoscopic removal of a vocal-fold lesion with microscope or telescope guidance and graft placement, reported when both excision and grafting are performed. Compare 31546 office and facility rates across CMS payment localities in Wyoming.
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 31546 in Wyoming?
Wyoming 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
$448.70
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Laryngology surgery
About 31546: Vocal fold lesion excision with graft
Direct laryngoscopic removal of a vocal-fold lesion with microscope or telescope guidance and graft placement, reported when both excision and grafting are performed.
This operative service removes a vocal-fold lesion through direct laryngoscopy, using an operating microscope or telescope, and includes placement of a graft. An otolaryngologist typically performs it in an operating room when lesion excision and graft placement are planned in the same operation. The graft is the key distinction from the related vocal-fold lesion excision without graft placement.
Report the service when the operative documentation supports lesion excision and graft placement; biopsy alone, injection, or laser destruction describes a different service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 31546
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU9.49 · 69%
- Practice expense (office) RVU2.93 · 21%
- Malpractice RVU1.37 · 10%
19
Medicare services in 2024 · #5942 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.
31546 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
31541 is used for operative excision of a tumor or vocal-cord stripping with microscope or telescope guidance; 31546 describes lesion excision with graft placement.
No office rate
31535 describes laryngoscopic biopsy for tissue sampling. Choose 31546 when the documented operation includes lesion excision and graft placement.
$507.97
31572 treats a lesion by laryngoscopic laser destruction; 31546 involves excision and graft placement.
Compare 31546 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$448.70
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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 31546 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,595
- Code
- 31546
- Physician work
- 9.49
- Practice expense
- 2.93
- Malpractice
- 1.37
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.49 | × 1.000 | 9.4900 |
| Practice expense | 2.93 | × 1.000 | 2.9300 |
| Malpractice | 1.37 | × 0.740 | 1.0138 |
| Total RVUs | 13.4338 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$448.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.49 | 1 |
| Practice expense | 2.93 | 1 |
| Malpractice | 1.37 | 0.74 |
(9.49 × 1 + 2.93 × 1 + 1.37 × 0.74) × $33.4009 = $448.70
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.
31546 billing questions
When should I choose this code over 31545?
Use 31546 when the vocal-fold lesion is excised and a graft is placed. The related 31545 service is the excision without graft placement.
Does this code include graft placement?
Yes. Graft placement is part of the service described by this code and is what distinguishes it from the related excision code without a graft.
Can I report a biopsy or laser treatment as this service?
No. A biopsy without definitive excision, or laser destruction without excision and graft placement, describes a different service.
How should a bilateral procedure be reported?
CMS identifies this as a bilateral procedure. Modifier 50 is paid at 150%.
How are related endoscopies priced when performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together.
Can an assistant or co-surgeon be paid for this operation?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted.
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.
3,59231540,,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
3,59631551,,Laryngoplasty laryngeal sten,A,,20.96,17.05,NA,17.05,,3.05,41.06,41.06,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,59731552,,Laryngoplasty laryngeal sten,A,,19.99,16.84,NA,16.84,,2.92,39.75,39.75,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,59831553,,Laryngoplasty laryngeal sten,A,,21.45,20.33,NA,20.33,,3.12,44.90,44.90,0,090,0.10,0.76,0.14,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,