Summary & Overview

CPT 31360: Laryngectomy Without Radical Neck Dissection

CPT code 31360 represents a total laryngectomy performed without radical neck dissection. The code captures a definitive surgical treatment for advanced laryngeal disease when voice‑preserving therapies are unsuitable. Nationally, this code is important for tracking high‑acuity otolaryngology procedures that drive inpatient surgical utilization, perioperative care needs, and long‑term rehabilitative services such as voice restoration and airway management.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the categories of payers that commonly reimburse this service.

The publication outlines benchmarks and billing considerations relevant to hospitals and surgical practices, summarizes typical perioperative resource use associated with the procedure, and highlights areas of policy relevance such as inpatient utilization, coding specificity, and implications for postoperative care pathways. Data limitations are noted where input fields are incomplete. The material is intended for billing managers, hospital administrators, and clinical leaders who need a national perspective on coding, utilization, and operational impacts tied to CPT code 31360.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 31360laryngectomyhead and neck surgerysurgical codinginpatient surgeryotolaryngologyprocedure codingairway surgery

Billing Code Overview

CPT code 31360 describes the surgical removal of the larynx (laryngectomy) performed without radical neck dissection. The procedure removes the voice box to treat invasive laryngeal disease when organ-preserving approaches are not appropriate.

Service Type: Surgical — Otolaryngology / Head and Neck Surgery

Typical Site of Service: Inpatient hospital or ambulatory surgical center, depending on clinical complexity and patient needs.

Clinical & Coding Specifications

Clinical Context

A 64-year-old male with a history of heavy smoking and progressive hoarseness is evaluated after laryngoscopy and biopsy confirm squamous cell carcinoma of the glottic larynx invading the vocal cords with airway compromise. Imaging shows disease confined to the larynx without evidence of fixed cervical nodes requiring radical neck dissection. After multidisciplinary tumor board review, the patient is scheduled for total laryngectomy to remove the entire larynx for definitive oncologic control.

The typical clinical workflow includes preoperative assessment with airway evaluation, staging CT or PET-CT, preoperative counseling regarding loss of natural voice and alternative communication (esophageal speech, tracheoesophageal puncture later), perioperative antibiotics and DVT prophylaxis, general endotracheal anesthesia, surgical removal of the larynx without radical neck dissection, possible concurrent selective neck dissection if indicated (coded separately), placement of a permanent tracheostomy, hemostasis, wound closure, and postoperative monitoring in a surgical or ICU setting. Postoperative care includes airway management, swallow assessment, stoma care education, and coordination for voice rehabilitation and adjuvant therapy as indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or complexity substantially exceeds that usually required for total laryngectomy.
`23`	Unusual anesthesia	Use when procedure performed under general anesthesia is unusually difficult and no regional anesthesia was possible.
`26`	Professional component	Use when reporting only the surgeon's professional service separate from facility billing, if applicable.
`50`	Bilateral procedure	Not typically applicable to `31360` but may be reported when bilateral intervention reporting conventions apply.
`51`	Multiple procedures	Use when other distinct procedures are performed the same operative session in addition to `31360`.
`52`	Reduced services	Use when the laryngectomy is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances after anesthesia has begun.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the laryngectomy.
`66`	Surgical team	Use when a surgical team approach is required for complex resections.
`78`	Unplanned return to the OR for a related procedure during the global period	Use for reopenings for hemorrhage or debridement related to the laryngectomy within the postoperative period.
`79`	Unrelated procedure or service by the same physician during the global period	Use when a distinct unrelated surgical procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides surgical assistance during the laryngectomy.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist — allowed services	Use when an advanced practice clinician billed under their own NPI provides qualifying services.

Taxonomy Code	Specialty	Notes
2086S0001X	Otolaryngology (ENT)	Primary specialty performing total laryngectomy procedures.
2080P0207X	Head and Neck Surgery	Surgeons focusing on oncologic resections of the larynx.
2086P0700X	Surgery - General	General surgeons who may participate in complex airway or reconstructive cases.
363LA2200X	Speech-Language Pathology	Postoperative voice and swallowing rehabilitation providers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C32.0`	Malignant neoplasm of glottis	Primary indication for total laryngectomy when disease is advanced or functionally unresectable.
`C32.1`	Malignant neoplasm of supraglottis	May require laryngectomy for extensive supraglottic tumors invading critical structures.
`C32.2`	Malignant neoplasm of subglottis	Subglottic tumors can necessitate total laryngectomy for oncologic control.
`C32.9`	Malignant neoplasm of larynx, unspecified	Used when laryngeal cancer is confirmed but anatomic subsite is not specified.
`Z90.2`	Acquired absence of larynx and trachea	Postoperative status code used after total laryngectomy for problem lists and history.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31500`	Intubation, endotracheal, emergency procedure	Used for airway management preoperatively or emergently prior to laryngectomy.
`31505`	Laryngoscopy, direct; diagnostic, with or without collection of specimen	Performed preoperatively for diagnostic assessment and tissue biopsy.
`31579`	Tracheostomy, temporary, planned or emergency (separate code may apply by technique)	A permanent tracheostomy is created during total laryngectomy; tracheostomy-related codes may be reported when appropriate.
`38999`	Unlisted procedure, hemic or radical neck dissection (note: use specific neck dissection codes when performed)	Used if neck dissection is required but does not match a specific CPT code; neck dissections are coded separately when performed in addition to `31360`.
`43280`	Esophagomyotomy or other esophageal procedures (example for tracheoesophageal puncture staging)	Codes related to later voice rehabilitation procedures such as tracheoesophageal puncture or prosthesis placement may be performed after laryngectomy.