How much does Medicare pay for CPT 31525?

Medicare allowed an average of $165.31 per service and paid $128.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $523.03, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31525?

Diagnostic exam of voice box using an endoscope. It was billed 48,116 times to 38,371 Medicare beneficiaries by 74 providers in 2024.

Does 31525 pay differently in an office than a hospital?

Yes. The allowed amount averaged $246.07 in an office setting and $160.65 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 31525 most?

Otolaryngology, with 38,364 services from 54 clinicians. Next are Physician Assistant, Nurse Practitioner, General Surgery.

CPT 31525

Diagnostic exam of voice box using an endoscope

$165.31Medicare-allowed amount per service, averaged across 48,116 services

Providers submitted

$523.03

Asking price, not received

Medicare allowed

$165.31

The fee schedule figure

Medicare paid

$128.23

Balance is patient coinsurance

Providers submitted an average of $523.03 for this code and Medicare allowed $165.31 — 3.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $128.23 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $246.07
Hospital / facility: $160.65

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,623 services were billed in an office setting and 45,493 in a facility.

Services: 48,116
Beneficiaries: 38,371
Providers billing it: 74
Total allowed: $7,954,056

What Medicare pays for CPT 31525

Across 48,116 services billed by 74 providers to 38,371 beneficiaries, Medicare allowed an average of $165.31 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 31525

Specialty	Services	Beneficiaries	Avg allowed	Providers
Otolaryngology	38,364	29,928	$170.69	54
Physician Assistant	7,353	6,488	$144.30	6
Nurse Practitioner	2,163	1,728	$136.37	2
General Surgery	100	99	$133.24	3
Maxillofacial Surgery	60	59	$82.14	4
Ambulatory Surgical Center	60	53	$459.43	4
Allergy/ Immunology	16	16	$231.75	1

31525 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	43,770	$164.32	$119.67	18
Texas	2,066	$139.86	$104.39	5
Nevada	987	$241.06	$184.35	1
Puerto Rico	218	$258.04	$188.11	4
Mississippi	216	$219.56	$189.57	4
Arizona	153	$176.61	$136.62	4
Pennsylvania	130	$104.48	$77.49	7
Florida	102	$171.41	$138.15	4
Ohio	80	$94.28	$73.91	5
Iowa	50	$183.94	$153.92	1
Michigan	47	$114.69	$88.39	3
Illinois	39	$92.02	$62.30	2
South Carolina	34	$429.57	$363.19	2
Washington	27	$260.73	$190.66	2
Utah	27	$220.57	$180.72	1
Georgia	22	$158.64	$131.40	2
Alabama	22	$75.00	$62.32	1
Hawaii	20	$79.77	$62.36	1
New Jersey	20	$90.44	$65.43	1
Tennessee	17	$138.05	$107.81	1
Kentucky	16	$106.47	$85.62	1
Arkansas	15	$113.48	$103.56	1
Maryland	13	$264.19	$196.77	1
Kansas	13	$75.27	$62.35	1
Massachusetts	12	$98.79	$67.71	1

Related codes

31575Diagnostic exam of voice box$115.61
31579Exam to assess movement of vocal cord flaps$185.10
31500Emergent insertion of breathing tube into windpipe$136.48
31505Diagnostic exam of voice box$73.30
31574Injection of substance to augment voice box$936.87
31571Injection into vocal cords$186.98
31502Change of breathing tube in windpipe$29.63
31541Removal of growth of tongue and/or stripping of vocal cord$330.99
31573Injection of drug into side of voice box$321.45

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.