Summary & Overview

CPT 31375: Laterovertical Hemilaryngectomy, Partial Laryngectomy

CPT code 31375 denotes a partial laryngectomy procedure—specifically a laterovertical hemilaryngectomy where a vocal cord and adjacent laryngeal cartilage are removed. This code is used to capture operative management of localized laryngeal disease, including malignant and select non-malignant conditions that require excision of vocal fold tissue. Accurate coding for this procedure matters nationally because it affects surgical quality reporting, hospital and surgeon reimbursement, and case mix classification for otolaryngology and head and neck surgical services.

Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a clinical and billing-focused overview of the procedure, describes typical settings of care, and presents what readers can expect in terms of benchmarks and policy context. Content covers coding intent and clinical indication, common payer considerations, and relevant practice implications for hospital and ambulatory surgical settings. Data not available in the input is noted where applicable.

Readers will learn the clinical scope captured by CPT code 31375, the typical site of service, the payers commonly involved in payment for these services, and where to look for additional billing specifics and payer policy updates.

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Billing Code Overview

CPT code 31375 describes a surgical procedure in which the provider removes part of the larynx (voice box). In a laterovertical hemilaryngectomy, the procedure specifically involves removal of a vocal cord and adjacent laryngeal cartilage.

Service type: Surgical excision of laryngeal structures involving partial laryngectomy
Typical site of service: Hospital operating room or ambulatory surgical center for otolaryngology/head and neck surgery

Clinical & Coding Specifications

Clinical Context

A typical patient is a 60-year-old male with a history of tobacco and alcohol use who presents with persistent hoarseness, hemoptysis, and a mass involving one vocal cord on laryngoscopy. Imaging (CT or MRI) and biopsy confirm a localized T1–T2 squamous cell carcinoma of the glottis limited to one vocal fold and adjacent laryngeal framework. The multidisciplinary team (otolaryngology–head and neck surgery, anesthesia, pathology, and speech-language pathology) coordinates care. On the day of service the patient undergoes a laterovertical hemilaryngectomy (CPT 31375) under general endotracheal anesthesia. The operative workflow includes direct laryngoscopy for assessment and exposure, excision of the affected vocal cord and adjacent thyroid cartilage (hemilaryngectomy), hemostasis, and layered closure as appropriate. Intraoperative frozen section pathology may be used to confirm margins. Postoperatively the patient is monitored in a post-anesthesia care unit with airway observation; speech-language pathology evaluates voice and swallowing prior to discharge. Follow-up includes pathology review, staging discussion, and adjuvant treatment planning (radiation oncology) if indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use if the hemilaryngectomy requires substantially greater effort, time, or technical difficulty than typical and the medical record documents justification.
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated but used due to an unusual circumstance that increases risk.
`26`	Professional component	Use when reporting only the surgeon’s professional component separate from facility technical services (rare for this OR procedure).
`50`	Bilateral procedure	Use if a bilateral laryngeal procedure were performed (generally not applicable to unilateral hemilaryngectomy but included for bilateral claims).
`51`	Multiple procedures	Use when `CPT 31375` is reported on the same day with additional unrelated surgical procedures; lists secondary procedures by descending RVUs.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as documented (e.g., aborted due to bleeding or unexpected finding).
`53`	Discontinued procedure	Use when the procedure is terminated due to an emergent clinical condition after anesthesia and is appropriately documented.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`66`	Surgical team	Use when a documented surgical team approach with multiple surgeons performs the operation.
`78`	Return to OR for related procedure during postoperative period	Use if the patient returns to the operating room for a related procedure during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is required and billed separately.
`81`	Minimum assistant surgeon	Use when a minimum assistant surgeon performs limited assistance.
`82`	Assistant surgeon (when qualified resident not available)	Use when a qualified resident is not available and an assistant is required.
`52`	Reduced services	Use when the surgeon documents a significant portion of the procedure was not performed.

Taxonomy Code	Specialty	Notes
207VC0100X	Otolaryngology (ENT)	Primary specialty performing hemilaryngectomy and laryngeal surgery.
207VP0125X	Head and Neck Surgery	Subspecialty focus on complex oncologic laryngeal resections.
208800000X	General Surgery	May perform head and neck procedures in some practice settings.
261QU0200X	Anesthesiology	Provides general endotracheal anesthesia and airway management for the procedure.
163WL0500X	Speech-Language Pathology	Performs perioperative voice and swallowing assessment and rehabilitation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C32.0`	Malignant neoplasm of glottis	Primary indication for hemilaryngectomy when cancer is localized to the vocal cords.
`C32.1`	Malignant neoplasm of supraglottis	May require partial laryngectomy if tumor involves lateral laryngeal structures.
`C32.2`	Malignant neoplasm of subglottis	Relevant when tumor extends inferiorly and resection margins must be planned.
`C32.9`	Malignant neoplasm of larynx, unspecified	Used when laryngeal malignancy is documented but precise subsite is not specified.
`J38.0`	Polyp of vocal cord and larynx	Benign lesions occasionally managed with excision; differentiation from malignancy is required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31505`	Laryngoscopy, direct, operative, with biopsy	Performed preoperatively or at time of surgery for diagnostic biopsy or assessment of margin.
`31599`	Unlisted procedure, larynx	Used for atypical laryngeal procedures or additional reconstructive maneuvers not described by a specific code.
`31365`	Laryngectomy, partial, e.g., cordectomy, vocal cord stripping	Alternative or less extensive excision codes for smaller lesions when hemilaryngectomy is not required.
`31620`	Tracheostomy, temporary or permanent	May be performed perioperatively if airway protection or prolonged ventilatory support is anticipated.
`88309`	Surgical pathology, gross and microscopic examination with special preparation	Pathology processing and interpretation of surgical specimens including margin assessment.