National Trends in Laryngeal Laser Surgery: Comparison of Operative Versus Office‐Based Procedures

• Published in: The Laryngoscope 2025-02, Vol.135 (2), p.823-828
• Main Authors: Scher, Maxwell, Shave, Samantha M., Tracy, Jeremiah C., Tracy, Lauren F.
• Format: Article
• Language: English
• Subjects: Ambulatory Surgical Procedures - statistics & numerical data; Ambulatory Surgical Procedures - trends; Humans; Laryngeal Diseases - surgery; laryngeal laser; laryngology; Laryngoscopy; Laryngoscopy - methods; Laryngoscopy - statistics & numerical data; Laser Therapy - methods; Laser Therapy - statistics & numerical data; Lasers; Medicare; Medicare Part B - statistics & numerical data; office procedures; office‐based; Trends; United States
• ISSN: 0023-852X; 1531-4995; 1531-4995
• DOI: 10.1002/lary.31847

Objective To analyze national trends in the prevalence of office‐based laryngeal ablative procedures and compare those with traditional operative excisional procedures utilizing direct laryngoscopy. Methodology For years 2013–2022, the US Medicare Part B claims database was searched for Current Procedural Terminology (CPT) codes 31572 (flexible laryngoscopy with laser ablation of lesion), 31540 (operative direct laryngoscopy with excision of lesion), 31541 (operative direct microlaryngoscopy with excision of lesion), and 31545 (operative direct microlaryngoscopy with excision of lesion and local tissue flap reconstruction). For each CPT code, the total number of charges billed to the Medicare database in each calendar year was recorded and annual trends were analyzed. Biopsy procedures were not included. Results The annual number of office‐based laser procedures (CPT 31572) remained relatively constant since the CPT code was introduced in 2017 (range: 18887–25241 procedures annually, trendline slope = +16, R2:0.02). Office‐based laser procedures comprised a small portion of total laryngeal excisional procedures (range: 8.4%–12.1%). The total number of operative laryngeal excisions, billed by CPT 31540 and 31541, declined over the studied time frame (Trendline slope = −132, R2:0.93; Trendline slope = −950, R2: 0.93 respectively). Conclusions Office‐based laser procedures comprise a small fraction of procedures to remove laryngeal lesions. The number of office‐based laser procedures has been relatively stable over the last 5 years. This finding contrasts with the prevailing health care trend toward office‐based procedures. Further research is needed to understand the decrease in operative laryngeal lesion excision procedures observed over the last 10 years. Level of Evidence 4 Laryngoscope, 135:823–828, 2025 Office‐based laser procedures comprise a small proportion of all excisional laryngeal procedures and has remained relatively stable over the last 5 years, contrasting with the prevailing health care trend toward office‐based procedures. Additionally, there has been a decrease in the number of operative laryngeal lesion excision procedures over the last 10 years.