CPT 31420 Epiglottidectomy Reimbursement | OpenPayer

Summary & Overview

CPT 31420: Epiglottidectomy (Excision of Epiglottis)

CPT code 31420 represents an epiglottidectomy — the partial or complete surgical excision of the epiglottis. This procedure is performed for patients with obstructive symptoms such as snoring, swallowing impairment, or for removal of neoplastic lesions involving the epiglottis. Nationally, epiglottidectomy remains an important but relatively specialized otolaryngology procedure because of its role in airway protection, deglutition, and oncologic management.

Key payers discussed include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers commonly cover surgical head and neck services of this type. The publication will also summarize common billing modifiers and operational considerations relevant to coding and claims workflows.

The report provides benchmarks where available, highlights recent policy clarifications affecting surgical head and neck coding, and outlines the clinical scenarios that most commonly drive use of this code. Data not available in the input for specific diagnosis pairings, associated taxonomies, and payer-specific reimbursement rates is stated where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare31420CPTEpiglottidectomyOtolaryngologyHead and Neck SurgerySurgical ProceduresAirway ManagementDysphagia

Billing Code Overview

CPT code 31420 describes an epiglottidectomy, a surgical procedure in which the provider excises all or part of the patient’s epiglottis. The service addresses conditions such as difficulty swallowing (dysphagia), obstructive symptoms like snoring, or removal of a tumor involving the epiglottis.

Service type: Surgical — Head and Neck / Otolaryngology

Typical site of service: Operating room or ambulatory surgical center, with care often initiated through otolaryngology clinics for evaluation and directed to a surgical setting for definitive excision.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who presents with progressive dysphagia, sensation of throat obstruction, or obstructive sleep symptoms with suspected epiglottic hypertrophy or neoplasm. Workup commonly includes flexible fiberoptic laryngoscopy, cross-sectional imaging (CT or MRI) when a mass is suspected, and preoperative anesthetic evaluation due to airway risk. The procedure 31420 (epiglottidectomy) is performed in the operating room under general anesthesia with endotracheal intubation or alternative airway technique. Intraoperative steps include suspension laryngoscopy or direct laryngoscopy, visualization of the epiglottis, and excision of all or part of the epiglottis using cold instruments, microdebrider, or laser. Hemostasis is achieved, specimens are sent to pathology when indicated, and the patient is observed in a post-anesthesia care unit with attention to airway edema and swallowing function. Typical sites of service include an outpatient ambulatory surgery center for elective, low-risk cases, or an inpatient hospital operating room for complex tumors, shared airway cases, or patients requiring postoperative observation. Common clinical teams involved are otolaryngology-head and neck surgery, anesthesiology, pathology, and speech-language pathology for swallowing assessment when needed.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

CPT 31395: Pharyngolaryngectomy with Reconstruction

CPT-31382-ANTEROVERTICAL-HEMILARYNGECTOMY-PARTIAL-LARYNGECTOMY

CPT 31382: Anterovertical Hemilaryngectomy, Partial Laryngectomy

CPT-31300-LARYNGECTOMY-CORDECTOMY-LARYNGEAL-TUMOR-EXCISION

CPT 31300: Laryngeal Tumor or Laryngocele Excision with Cordectomy

CPT-31368-SUPRAGLOTTIC-LARYNGECTOMY-RADICAL-NECK-DISSECTION

CPT 31368: Supraglottic Laryngectomy with Radical Neck Dissection

CPT-31380-ANTEROVERTICAL-HEMILARYNGECTOMY-PARTIAL-LARYNGECTOMY

CPT 31380: Anterovertical Hemilaryngectomy (Partial Laryngectomy)

CPT-31375-LATEROVERTICAL-HEMILARYNGECTOMY-PARTIAL-LARYNGECTOMY

CPT 31375: Laterovertical Hemilaryngectomy, Partial Laryngectomy

CPT-31365-LARYNGECTOMY-WITH-RADICAL-NECK-DISSECTION

CPT 31365: Laryngectomy with Radical Neck Dissection

CPT-31367-SUBTOTAL-LARYNGECTOMY-SUPRAGLOTTIC-EXCISION

CPT 31367: Subtotal (Supraglottic) Laryngectomy

CPT-31360-LARYNGECTOMY-WITHOUT-RADICAL-NECK-DISSECTION

CPT 31360: Laryngectomy Without Radical Neck Dissection

CPT-31370-PARTIAL-LARYNGECTOMY-HORIZONTAL-APPROACH

CPT 31370: Partial Laryngectomy, Horizontal Approach

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Taxonomy Code	Specialty	Notes
`207Y00000X`	Otolaryngology-Head & Neck Surgery	Primary specialty performing `31420`; includes airway and tumor resections.
`207L00000X`	Oral and Maxillofacial Surgery	May perform transoral resections in some institutions.
`2084P0800X`	Anesthesiology	Provides airway management and anesthesia for airway procedures.
`2085R0201X`	Pathology	Processes surgical specimens and provides diagnostic interpretation.
`234Z00000X`	Speech-Language Pathology	Performs postoperative swallowing and aspiration risk assessments.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J38.0`	Diseases of vocal cords and larynx, unspecified	May be listed when laryngeal pathology includes epiglottic involvement causing airway or voice symptoms.
`J38.6`	Other diseases of larynx, unspecified	Used for non-specific laryngeal disorders when epiglottic pathology contributes to symptoms.
`R13.10`	Dysphagia, unspecified	Common presenting symptom that can prompt evaluation and lead to epiglottidectomy for obstructive causes.
`G47.33`	Obstructive sleep apnea (adult)	Epiglottic prolapse or hypertrophy can contribute to sleep-disordered breathing and be an indication for partial epiglottidectomy.
`C31.9`	Malignant neoplasm of nasal cavity and middle ear, unspecified	Data not typically direct to epiglottis; use `C32.x` family for laryngeal malignancies when applicable.
`C32.9`	Malignant neoplasm of larynx, unspecified	Malignancy involving the epiglottis is an indication for partial or total epiglottidectomy with oncologic margins.
`K21.9`	Gastro-esophageal reflux disease without esophagitis	Laryngopharyngeal reflux may contribute to chronic epiglottic inflammation and hypertrophy prompting surgical management.
`R07.0`	Pain in throat	Symptom code that may accompany epiglottic masses or inflammation leading to surgical intervention.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31575`	Laryngoscopy, direct, with tracheal intubation, diagnostic	Preoperative airway assessment and may be used intraoperatively for visualization prior to `31420`.
`31579`	Laryngoscopy, direct, with biopsy	Often performed when a suspicious lesion of the epiglottis requires tissue diagnosis in the same session or prior to `31420`.
`31528`	Laryngoscopy, flexible or rigid, diagnostic; with topical anesthesia	Common diagnostic office or OR procedure to evaluate the epiglottis prior to definitive surgery.
`31625`	Bronchoscopy, rigid or flexible; diagnostic, with laryngoscopy/bronchoscopy under general anesthesia	May be performed in complex airway cases or when concurrent airway evaluation below the larynx is needed.
`43246`	Esophagoscopy, flexible, transoral; diagnostic, with or without collection of specimen(s) by brushing or washing	Performed when dysphagia evaluation extends to the hypopharynx or proximal esophagus in the same episode of care.
`88305`	Surgical pathology, gross and microscopic examination	Billing code for pathology processing and interpretation of excised epiglottic tissue when a specimen is submitted.

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