How much does Medicare pay for CPT 31575?

Medicare allowed an average of $115.61 per service and paid $86.44 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $361.72, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31575?

Diagnostic exam of voice box using a flexible endoscope. It was billed 510,976 times to 425,756 Medicare beneficiaries by 8,057 providers in 2024.

Does 31575 pay differently in an office than a hospital?

Yes. The allowed amount averaged $122.95 in an office setting and $65.54 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 31575 most?

Otolaryngology, with 439,353 services from 6,234 clinicians. Next are Physician Assistant, Nurse Practitioner, Radiation Oncology.

CPT 31575

Diagnostic exam of voice box using a flexible endoscope

$115.61Medicare-allowed amount per service, averaged across 510,976 services

Providers submitted

$361.72

Asking price, not received

Medicare allowed

$115.61

The fee schedule figure

Medicare paid

$86.44

Balance is patient coinsurance

Providers submitted an average of $361.72 for this code and Medicare allowed $115.61 — 3.1× 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 $86.44 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $122.95
Hospital / facility: $65.54

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. 445,664 services were billed in an office setting and 65,312 in a facility.

Services: 510,976
Beneficiaries: 425,756
Providers billing it: 8,057
Total allowed: $59,073,935

What Medicare pays for CPT 31575

Across 510,976 services billed by 8,057 providers to 425,756 beneficiaries, Medicare allowed an average of $115.61 per service. That is 1.2 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 31575

Specialty	Services	Beneficiaries	Avg allowed	Providers
Otolaryngology	439,353	364,606	$119.32	6,234
Physician Assistant	34,560	30,765	$95.01	906
Nurse Practitioner	21,122	18,608	$90.46	552
Radiation Oncology	9,039	6,246	$80.54	231
General Surgery	1,538	1,343	$97.58	31
Allergy/ Immunology	802	544	$131.28	9
Surgical Oncology	640	473	$87.83	12
Plastic and Reconstructive Surgery	567	455	$118.97	14
Pulmonary Disease	459	453	$64.99	18
Emergency Medicine	430	325	$141.78	2
Internal Medicine	406	266	$139.80	8
Maxillofacial Surgery	367	275	$83.03	7
Ophthalmology	260	214	$123.35	3
Medical Oncology	242	209	$76.24	5
Osteopathic Manipulative Medicine	191	145	$117.07	2

31575 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
Florida	51,713	$118.59	$87.91	598
California	47,301	$125.89	$83.36	636
New York	47,195	$133.86	$86.49	588
Pennsylvania	29,392	$110.68	$82.50	397
Texas	28,296	$113.13	$87.03	555
New Jersey	20,317	$137.63	$91.62	257
Massachusetts	19,374	$116.69	$78.91	237
Illinois	18,804	$112.84	$81.32	297
Georgia	15,387	$113.95	$87.84	278
Ohio	15,295	$101.24	$78.99	279
Virginia	15,152	$114.58	$85.34	218
North Carolina	14,561	$110.19	$86.59	267
Maryland	12,826	$125.70	$88.22	163
Michigan	12,190	$107.62	$80.23	232
South Carolina	12,079	$108.64	$87.52	172
Tennessee	10,814	$102.94	$85.11	190
Arizona	9,421	$113.08	$87.21	137
Missouri	8,502	$105.73	$82.91	162
Washington	8,450	$119.04	$83.09	176
Indiana	7,817	$107.69	$88.48	160
Colorado	7,407	$121.22	$87.71	150
Alabama	6,846	$103.17	$88.04	122
Louisiana	6,707	$101.80	$82.78	145
Minnesota	6,388	$107.23	$80.13	158
Connecticut	6,210	$127.29	$88.80	110
Iowa	5,752	$98.19	$79.66	91
Wisconsin	5,681	$96.55	$74.72	146
Kentucky	5,659	$105.97	$87.59	104
Mississippi	5,320	$106.17	$89.97	62
Oregon	4,577	$114.84	$84.76	107
Kansas	4,380	$99.13	$80.49	79
Oklahoma	4,334	$107.45	$86.12	78
Nebraska	3,526	$98.63	$80.45	74
Arkansas	3,359	$103.84	$88.10	63
New Hampshire	3,301	$89.25	$64.62	53
Delaware	2,536	$120.40	$91.23	24
West Virginia	2,433	$93.51	$72.63	48
Utah	2,175	$111.30	$86.99	64
Idaho	2,088	$97.31	$79.75	43
Nevada	2,042	$117.63	$90.71	31
Montana	2,017	$102.61	$74.09	37
South Dakota	1,984	$92.22	$70.39	39
Maine	1,740	$87.85	$65.99	34
New Mexico	1,510	$89.72	$68.80	29
District of Columbia	1,398	$129.49	$83.90	24
Hawaii	1,318	$101.37	$73.87	19
North Dakota	1,088	$71.90	$54.25	28
Rhode Island	1,026	$121.46	$91.07	22
Alaska	854	$135.77	$89.91	23
Vermont	816	$64.48	$47.21	16
Wyoming	773	$118.53	$88.49	14
Puerto Rico	407	$118.11	$86.73	15
U.S. Virgin Islands	220	$117.47	$84.47	3
Guam	103	$122.33	$93.39	1
AP	60	$115.05	$93.07	1
ZZ	55	$115.91	$89.78	1

Related codes

31579Exam to assess movement of vocal cord flaps$185.10
31525Diagnostic exam of voice box$165.31
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.