🫁 CPT 31300 — Laryngotomy (Thyrotomy, Laryngofissure), With Removal Of Tumor Or Laryngocele, Cordectomy
Quick Reference
wRVU: 14.86 (flag for CY2026 MPFS confirmation) | Global Period: 090 | Assistant Payable: Yes | Bilateral Indicator: 0 Rule: This code carries a full 90-day global surgical period reflecting the major open surgical approach involved. The bilateral indicator of 0 reflects that the larynx is a single midline structure, so -RT/-LT laterality modifiers and modifier -50 do not apply to this code even though a specific vocal cord (right or left) may be addressed during cordectomy. Because the descriptor bundles three distinct possible interventions — tumor removal, laryngocele removal, and cordectomy — only one unit is reported regardless of how many of these elements are performed in the same operative session.
📋 Clinical Description
CPT 31300 describes an open surgical approach to the larynx via thyrotomy or laryngofissure, performed to excise a laryngeal tumor, remove a laryngocele, or complete a cordectomy when the pathology cannot be adequately addressed endoscopically. The surgeon splits the thyroid cartilage in the midline to expose the endolaryngeal structures, then resects the tumor, sac, or vocal cord tissue under direct open visualization before reconstructing and closing the laryngeal framework. This code is distinguished from 31320, which describes the identical open laryngofissure approach performed purely for diagnostic purposes without therapeutic excision, and from 31370 through 31382, which describe progressively more extensive partial laryngectomy procedures removing entire anatomic subunits of the larynx rather than a discrete tumor, laryngocele, or vocal cord segment.
An internal laryngocele or a laryngeal tumor not amenable to transoral endoscopic laser resection typically drives selection of this open approach; when the same pathology can instead be addressed via a microlaryngoscopic or endoscopic technique, codes from the 31540-31546 series apply instead, and open laryngotomy under 31300 is reserved for cases where tumor size, location, or airway anatomy precludes an endoscopic approach. When the tumor identified intraoperatively proves to require a more extensive anatomic resection than a discrete cordectomy — for example, an entire hemilarynx — the more extensive partial laryngectomy codes supersede 31300 rather than being reported in addition to it.
This procedure may be performed in the following clinical contexts:
- Laryngeal malignancy not amenable to endoscopic resection — an early-stage glottic or supraglottic carcinoma too extensive or poorly positioned for transoral laser microsurgery is excised via open laryngofissure.
- Symptomatic internal laryngocele — an air-filled or mucus-filled saccular dilation causing airway compromise or voice change is excised through the open approach when endoscopic marsupialization is not feasible.
- Recurrent or endoscopically inaccessible vocal cord lesion — a lesion previously treated endoscopically that recurs, or one located in a position difficult to reach transorally, may require open cordectomy.
- Benign laryngeal tumor with airway obstruction — a benign neoplasm causing significant airway narrowing is removed via open approach when the size or vascularity of the lesion makes endoscopic excision unsafe.
- Combined tumor and laryngocele pathology — when a laryngeal tumor and a concurrent laryngocele are both addressed in the same open procedure, only a single unit of 31300 is reported, since the descriptor already encompasses both indications.
🔬 Anatomical & Procedural Considerations
| Variant | Mechanism | Key Notes |
|---|---|---|
| Tumor excision via laryngofissure | The thyroid cartilage is split in the midline (thyrotomy), the endolarynx is opened, and the tumor is excised under direct visualization with margins assessed intraoperatively, often with frozen section confirmation. | Documentation should specify the tumor’s location (glottic, supraglottic, or subglottic) and whether clear margins were achieved, since this drives both the paired ICD-10-CM code and any staging implications for the inpatient record. |
| Laryngocele excision | The laryngofissure approach exposes the saccular herniation of laryngeal mucosa, which is dissected free from surrounding tissue and excised at its base, with the laryngeal framework reconstructed afterward. | The operative note should distinguish an internal (intralaryngeal) laryngocele addressed via this open approach from an external or combined laryngocele that may require an additional external neck approach reported separately. |
| Cordectomy | All or part of a vocal cord is excised through the open laryngofissure, typically for a glottic lesion involving the vocal fold itself, with reconstruction of the remaining laryngeal mucosa to optimize postoperative voice outcome. | The extent of cord removed (partial versus complete) should be documented, as this affects postoperative voice rehabilitation planning even though it does not change the CPT code selection itself. |
Clinical Pearl
The single most important documentation element distinguishing 31300 from the more extensive partial laryngectomy codes (31370-31382) is confirmation that the resection was limited to a tumor, laryngocele, or vocal cord segment rather than an entire anatomic subunit of the larynx (hemilarynx, supraglottis, etc.). Operative notes that describe removal of an entire laryngeal subunit should be reviewed carefully, since payers and internal audit teams frequently flag 31300 claims that, on closer review of the pathology and operative description, actually meet the definition of a more extensive partial laryngectomy code.
✅ Procedure Includes
- Preoperative airway assessment and general anesthesia with a secured airway, typically via tracheostomy or endotracheal intubation performed as part of the approach.
- The thyrotomy/laryngofissure incision itself, splitting the thyroid cartilage in the midline to expose the endolarynx.
- The core excisional step — removal of the tumor, laryngocele, or vocal cord segment under direct open visualization.
- Intraoperative margin assessment, including frozen section pathology review when performed for a suspected or confirmed malignancy.
- Reconstruction and closure of the laryngeal framework and overlying soft tissue following excision.
- Immediate postoperative airway management and monitoring, including any temporary tracheostomy care related to the approach itself.
❌ Excludes / Do Not Report Together
| Code | Description | Relationship |
|---|---|---|
| 31320 | Laryngotomy (thyrotomy, laryngofissure); diagnostic | 31320 is reserved for a purely diagnostic laryngofissure without therapeutic excision; when a tumor, laryngocele, or vocal cord segment is actually removed in the same session, 31300 supersedes 31320 rather than both being reported. |
| 31370 | Partial laryngectomy (hemilaryngectomy); horizontal | When the intraoperative extent of resection proves to be a full anatomic hemilaryngectomy rather than a discrete tumor or cord excision, 31370 becomes the correct code and 31300 should not be separately reported for the same operative session. |
| 31360 | Laryngectomy; total, without radical neck dissection | If the extent of disease requires total laryngectomy rather than a limited tumor, laryngocele, or cordectomy resection, 31360 is the appropriate code and represents the more extensive procedure that would subsume any component addressed under 31300. |
| 31541/31546 series | Endoscopic laryngeal procedures with lesion removal or reconstruction | These endoscopic codes describe a fundamentally different (transoral) surgical approach; when the same lesion is addressed endoscopically rather than via open laryngofissure, the endoscopic code applies instead of 31300, and the two approaches are not reported together for the same lesion. |
| Tracheostomy codes (313XX series) | Separate tracheostomy procedure | A tracheostomy performed purely as an airway-securing adjunct to the laryngotomy is generally considered part of the global surgical package; a separately reportable tracheostomy requires documentation of independent medical necessity distinct from airway access for this procedure. |
Bundling Alert
The 90-day global period bundles all routine postoperative care, including airway monitoring, wound checks, and voice therapy assessments performed as part of expected recovery, into the single payment for [31300], and unrelated E/M services during that window require modifier -24 with clear documentation of the unrelated condition. Because this procedure closely parallels the more extensive partial and total laryngectomy codes in both approach and anatomic region, claims that describe removal of an entire anatomic subunit rather than a discrete tumor, laryngocele, or cord segment are a frequent target for payer downcoding or upcoding review depending on which direction the discrepancy runs.
🌳 Code Tree — Surgery: Respiratory System, Larynx
CPT 31300-31599 Surgery: Respiratory System, Larynx and Trachea/Bronchi
│
├── 31200-31237 Excision (Nasal/Sinus, unrelated subsection reference)
│
├── 31300-31320 Laryngotomy
│ ├── ▶▶ 31300 ◀◀ Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy ← YOU ARE HERE (Global: 090)
│ └── 31320 Laryngotomy (thyrotomy, laryngofissure); diagnostic (Global: 090)
│
├── 31360-31382 Laryngectomy (Total and Partial)
│ ├── 31360 Laryngectomy; total, without radical neck dissection (Global: 090)
│ ├── 31365 Laryngectomy; total, with radical neck dissection (Global: 090)
│ ├── 31367 Laryngectomy; subtotal supraglottic, without radical neck dissection (Global: 090)
│ ├── 31370 Partial laryngectomy (hemilaryngectomy); horizontal (Global: 090)
│ ├── 31375 Partial laryngectomy (hemilaryngectomy); laterovertical (Global: 090)
│ ├── 31380 Partial laryngectomy (hemilaryngectomy); anterovertical (Global: 090)
│ └── 31382 Partial laryngectomy (hemilaryngectomy); antero-latero-vertical (Global: 090)
│
└── 31390-31420 Laryngectomy with Pharyngectomy/Other Extended Resection
├── 31390 Laryngectomy, total, with radical neck dissection; without preservation of larynx
└── 31395 Laryngectomy, total, with radical neck dissection; with reconstruction💰 RVU & Reimbursement Profile
| Component | Value |
|---|---|
| Work RVU | 14.86 (verify against current CY2026 CMS MPFS) |
| Global Period | 090 (90 days) |
| Bilateral Indicator | 0 — not subject to bilateral payment reduction rules; the larynx is a single midline structure and this code is reported once per operative session regardless of which vocal cord is involved |
| Assistant Surgeon | ✅ Payable |
| Co-Surgeon | ✅ Applicable when performed with a separately identifiable second surgical team, such as a reconstructive surgeon |
| Team Surgery | ❌ Not typically applicable |
| PC/TC Split | ❌ No — procedure code only (Indicator 0) |
| Modifier -51 Exempt | No |
| Anesthesia | General anesthesia with secured airway (endotracheal intubation or tracheostomy), separately billable under the 00XXX series when administered by a separate anesthesia provider |
Bilateral Billing Rules
This code does not carry bilateral billing applicability, since the larynx is a single, unpaired midline anatomic structure and the bilateral indicator is 0. Even when a specific side of the vocal cord is documented (right versus left) for clinical or pathology-reporting purposes, this does not translate into -RT/-LT modifier use or bilateral payment rules for this CPT code, and coders should not append laterality modifiers to 31300 despite the vocal cords themselves being paired structures.
🏷️ Modifier Reference
| Modifier | Name | When to Apply |
|---|---|---|
| -22 | Increased Procedural Services | Applied when the extent of tumor invasion, scarring from prior treatment, or anatomic distortion makes the procedure substantially more extensive than typical; documentation must quantify the additional time and complexity involved. |
| -51 | Multiple Procedures | Applied when 31300 is performed alongside other surgical procedures in the same operative session, appended to the lower-valued code in the multiple-procedure fee reduction sequence. |
| -52 | Reduced Services | Applied when the planned resection is only partially completed, such as when intraoperative findings limit the extent of excision achievable; the reason for the reduction must be documented. |
| -53 | Discontinued Procedure | Applied when the procedure is terminated due to a patient safety concern, such as an unstable airway or hemodynamic instability, before the planned resection is completed. |
| -58 | Staged or Related Procedure | Applied when a planned staged procedure, such as a delayed reconstruction or a second-look excision, is performed during the 90-day global window. |
| -59 | Distinct Procedural Service | Applied when 31300 is performed at a distinct anatomic site or session from another bundled procedure and the payer would otherwise apply an inappropriate NCCI edit. |
| -62 | Two Surgeons | Applied when two surgeons of different specialties each perform a distinct portion of the procedure as co-surgeons, with each surgeon billing 31300 with modifier -62. |
| -78 | Unplanned Return to Operating/Procedure Room | Applied when an unplanned return to the OR is required during the global period for a complication of the original excision, such as postoperative hemorrhage or airway compromise. |
| -79 | Unrelated Procedure During Postoperative Period | Applied when an unrelated procedure is performed during the 90-day global window following the original 31300 procedure. |
🩺 Common ICD-10-CM Pairings
Primary Diagnosis Group
| ICD-10 | Description | HCC? | Notes |
|---|---|---|---|
| C32.0 | Malignant neoplasm of glottis | ✅ HCC 12 (flag for CMS-HCC V28 verification) | Supports 31300 when the resected lesion is a glottic carcinoma not amenable to endoscopic laser resection; confirm the specific laryngeal subsite documented in the pathology report before finalizing this code. |
| C32.1 | Malignant neoplasm of supraglottis | ✅ HCC 12 (flag for CMS-HCC V28 verification) | Used when the tumor is located in the supraglottic region rather than the true vocal cords; verify subsite documentation matches this specific code rather than an unspecified laryngeal malignancy code. |
| C32.2 | Malignant neoplasm of subglottis | ✅ HCC 12 (flag for CMS-HCC V28 verification) | Used when the tumor arises below the vocal cords in the subglottic region; this subsite carries distinct staging and treatment implications from glottic or supraglottic disease. |
| J38.7 | Other diseases of larynx | ❌ No | The standard code for internal laryngocele; documentation should confirm this is truly a laryngocele rather than a laryngeal cyst or other structural anomaly, since J38.7 is a nonspecific “other” category code. |
| D14.1 | Benign neoplasm of larynx | ❌ No | Supports 31300 when the excised lesion is confirmed benign on pathology, such as a laryngeal papilloma or fibroma too extensive for endoscopic removal. |
Secondary Group
| ICD-10 | Description | HCC? | Notes |
|---|---|---|---|
| J38.3 | Other diseases of vocal cords | ❌ No | Reported as a secondary diagnosis when a distinct vocal cord pathology, such as a granuloma or nodule, is addressed via cordectomy in the same session as tumor or laryngocele excision. |
| R06.89 | Other abnormalities of breathing | ❌ No | Supports medical necessity when airway compromise from the laryngeal mass or laryngocele is a documented presenting symptom driving surgical intervention. |
Etiology / Complication
| ICD-10 | Description | HCC? | Notes |
|---|---|---|---|
| F17.210 | Nicotine dependence, cigarettes, uncomplicated | ❌ No | Frequently reported as a contributing etiology for laryngeal malignancy and is relevant to smoking-cessation counseling documentation requirements in the inpatient record. |
| T81.4XXA | Infection following a procedure, initial encounter | ❌ No | Reported when a postoperative wound or laryngeal infection develops following the laryngotomy, distinct from any preexisting infectious process. |
Coding Specificity Reminder
The most commonly missed specificity element for this code family is the precise laryngeal subsite (glottis, supraglottis, or subglottis) for malignant neoplasms, since C32 category codes require this distinction and it directly affects both staging accuracy and risk-adjustment mapping. When the pathology report or operative note does not clearly specify the subsite, or when only a nonspecific “laryngeal cancer” diagnosis is documented, a query should be initiated before defaulting to the unspecified code C32.9. ICD-10-CM specificity requirements are not optional, and subsite-level precision here has direct downstream implications for both DRG assignment and quality reporting.
🏥 MS-DRG Considerations
CPT 31300 is a major open surgical procedure that is directly relevant to inpatient MS-DRG assignment. When laryngotomy with tumor, laryngocele, or cordectomy resection is performed on an inpatient basis — as is typical given the airway management, general anesthesia, and postoperative monitoring requirements involved — the case maps to MDC 3 (Diseases and Disorders of the Ear, Nose, Mouth, and Throat) and typically groups to the Major Head and Neck Procedures DRG family (DRG 129, 130, or 131), with the specific DRG determined by the presence of a CC or MCC. The principal diagnosis selected — most commonly a laryngeal malignancy code from the C32 category or the laryngocele code J38.7 — combined with the ICD-10-PCS procedure code drives DRG grouping, and accurate capture of any postoperative complications (such as airway compromise, hemorrhage, or infection) as secondary diagnoses is essential to ensure the CC/MCC tier reflects the actual complexity and resource utilization of the admission.
🔧 ICD-10-PCS Equivalents
Note
Inpatient PCS coding for this procedure is common and directly meaningful to DRG assignment, since laryngotomy with tumor or laryngocele excision is typically performed in the inpatient hospital setting. The key root operation distinction is Excision (removal of only a portion of the larynx or vocal cord, appropriate for a discrete tumor, laryngocele, or partial cordectomy) versus Resection (removal of the entire body part), which would instead align with the more extensive partial or total laryngectomy codes (31360-31382) rather than 31300.
| PCS Code | Full Description | Modality |
|---|---|---|
0CBS0ZZ | Excision of Larynx, Open Approach | Tumor or laryngocele excision via open laryngofissure |
0CTS0ZZ | Resection of Larynx, Open Approach | Used only if the entire larynx is removed, which would not typically align with 31300 |
0CBC0ZZ | Excision of Right Vocal Cord, Open Approach | Cordectomy involving the right vocal cord |
0CBD0ZZ | Excision of Left Vocal Cord, Open Approach | Cordectomy involving the left vocal cord |
PCS Character Analysis — 0CBS0ZZ
| Position | Character | Value | Definition |
|---|---|---|---|
| 1 | Section | 0 | Medical and Surgical — the section covering all standard operative root operations. |
| 2 | Body System | C | Mouth and Throat — the PCS body system that includes the larynx and vocal cords. |
| 3 | Root Operation | B | Excision — cutting out or off, without replacement, a portion of the larynx; matches the discrete tumor, laryngocele, or cord excision described by the CPT code. |
| 4 | Body Part | S | Larynx — the overall laryngeal structure addressed when the excision is not limited to a single vocal cord. |
| 5 | Approach | 0 | Open — a direct surgical incision (thyrotomy/laryngofissure) is used to access the endolarynx, consistent with the operative technique described for this procedure. |
| 6 | Device | Z | No Device — no implant or graft is left in place as part of the excisional procedure itself. |
| 7 | Qualifier | Z | No Qualifier — no additional qualifying detail applies to this excision. |
Root Operation Comparison
- Use Excision (B) when only a discrete tumor, laryngocele, or portion of a vocal cord is removed, leaving the remainder of the laryngeal framework intact, consistent with the CPT 31300 descriptor.
- Use Resection (T) only if intraoperative findings require removal of an entire anatomic laryngeal subunit or the whole larynx, which would more appropriately align with the partial or total laryngectomy CPT codes (31360-31382) rather than 31300.
- When the specific vocal cord addressed is clinically or pathologically significant, assign the vocal-cord-specific body part value rather than the general Larynx value to preserve documentation granularity in the facility record.
📝 Coding Examples
Example 1
Clinical Scenario: A 61-year-old male with a documented T1a glottic squamous cell carcinoma involving the right vocal cord presents for definitive surgical management after being deemed a poor candidate for transoral endoscopic laser resection due to anterior commissure involvement and prior radiation exposure limiting endoscopic visualization. The surgeon performs an open thyrotomy approach, incising the thyroid cartilage in the midline to expose the endolarynx, and excises the tumor along with the involved portion of the right vocal cord. Frozen section margins are confirmed clear intraoperatively, and the laryngeal framework is reconstructed and closed in standard fashion. The patient is admitted postoperatively for airway monitoring given the open approach and prior radiation history.
| Field | Code | Rationale |
|---|---|---|
| CPT | 31300 | The operative note documents an open laryngofissure approach with tumor and partial vocal cord excision, precisely matching the 31300 descriptor rather than a more extensive partial laryngectomy, since only the involved cord segment was removed. |
| PDx | C32.0 | Malignant neoplasm of glottis is the most specific code supporting the primary indication for surgery, based on the documented glottic subsite of the tumor. |
Note
No modifier is required in this straightforward single-procedure scenario; the inpatient admission itself is supported by the open surgical approach and the airway monitoring requirement following prior radiation, and this context should be reflected in the admission history and physical documentation.
Example 2
Clinical Scenario: A 45-year-old female presents with progressive hoarseness and intermittent stridor found to be caused by a large internal laryngocele on preoperative imaging that extends beyond what can be safely marsupialized endoscopically. During the open laryngofissure procedure, the surgeon also identifies and biopsies a small, previously undetected contralateral vocal cord lesion, which is separately excised and sent for pathology. The laryngocele excision and the contralateral cord lesion excision are performed through the same laryngofissure incision but represent two distinct anatomic pathologies addressed in the same session.
| Field | Code | Rationale |
|---|---|---|
| CPT 1 | 31300 | The primary laryngocele excision via open laryngofissure meets the full 31300 descriptor. |
| CPT 2 | 31300-59 | The additional, anatomically distinct contralateral vocal cord lesion excision performed in the same session may require modifier -59 or an appropriate X-modifier to document that it represents a separate, medically necessary excision beyond the primary laryngocele procedure, though many payers will bundle a second unit of an identical code and this should be confirmed against payer-specific policy before submission. |
| PDx | J38.7 | Other diseases of larynx supports the primary laryngocele indication driving the admission and procedure. |
Warning
Reporting a second unit of the same CPT code for a second, distinct lesion in the same session is unusual and carries meaningful audit risk; documentation must be unambiguous that two truly separate anatomic pathologies were addressed, and coding leadership or the payer’s specific bundling policy should be consulted before finalizing this claim pattern.
Example 3
Clinical Scenario: A 58-year-old male undergoes open laryngotomy with excision of a supraglottic tumor. On postoperative day 5, still within the inpatient stay, he develops acute airway edema and stridor requiring an unplanned return to the operating room for evacuation of a hematoma compressing the airway at the surgical site. The hematoma evacuation is directly related to the original procedure and occurs well within the 90-day global period.
| Field | Code | Rationale |
|---|---|---|
| CPT | 31300-78 | The unplanned return to the operating room for a complication (compressive hematoma) directly related to the original excision, occurring within the 90-day global period, requires modifier -78 rather than an unmodified procedure code. |
| PDx | C32.1 | Malignant neoplasm of supraglottis continues to support medical necessity for the original procedure and the underlying reason for the admission. |
| SDx | T81.4XXA | Infection following a procedure would be reported instead if the complication were infectious rather than hemorrhagic; here, a postoperative hemorrhage/hematoma code should be used to reflect the actual complication documented. |
Global period reminder
Modifier -78 signals to the payer that this is a related, unplanned return during the original 90-day global period rather than a new, separately reimbursable initial procedure, and typically results in reduced reimbursement reflecting that a new global period does not restart under most payer policies. The operative note for the return procedure must clearly document that it was necessitated by a complication of the original laryngotomy to support -78 over an unmodified code.
⚠️ Common Coding Pitfalls
-
Confusing 31300 with more extensive partial laryngectomy codes: When the operative note describes removal of an entire anatomic laryngeal subunit (hemilarynx, full supraglottic structure) rather than a discrete tumor, laryngocele, or vocal cord segment, the claim should be coded to the appropriate 31370-31382 partial laryngectomy code rather than 31300, and misclassification in either direction creates meaningful reimbursement and compliance exposure.
-
Missing laryngeal subsite specificity on the diagnosis code: Reporting a nonspecific laryngeal malignancy code when the pathology report clearly identifies glottic, supraglottic, or subglottic involvement undermines both DRG accuracy and staging documentation; a query should be initiated whenever subsite-level specificity is achievable from the available documentation.
-
Applying -RT/-LT or -50 modifiers inappropriately: Because the larynx is a single midline structure with a bilateral indicator of 0, laterality modifiers and bilateral billing rules do not apply to 31300 even when a specific vocal cord side is clinically documented, and coders should not append these modifiers to this code.
-
Failing to distinguish endoscopic from open approach: When the operative note describes a transoral, endoscopic, or microlaryngoscopic technique rather than an open thyrotomy/laryngofissure incision, one of the endoscopic laryngeal codes (31540-31546 series) applies instead of 31300, and confusing the two approaches is a frequent source of claim denials.
-
Overlooking the 90-day global period for postoperative complications: Because this procedure carries a full 090 global period, any related complication requiring a return to the operating room must be reported with the appropriate modifier (-78 for unplanned related returns, -58 for planned staged procedures) rather than as a fresh, unmodified procedure code.
-
Inadequate documentation of tumor versus laryngocele versus cordectomy elements: Since the CPT descriptor bundles three distinct potential indications, the operative note should clearly document which specific element(s) were performed, since this affects both the paired diagnosis code selection and the clarity of the medical necessity narrative supporting the claim.
📎 Sources
1 AMA CPT 2026 Professional Edition · 2 AAPC Codify — CPT Code 31300, 2026 Update Verification · 3 CMS CY2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F) · 4 CMS RVU26 Relative Value Files (flagged for confirmation) · 5 CMS NCCI Policy Manual, Chapter 5 (Respiratory System), 2026 · 6 ICD-10-CM Official Guidelines for Coding and Reporting FY2026 · 7 ICD-10-PCS Official Guidelines for Coding and Reporting FY2026 · 8 CMS-HCC Model V28 Risk Adjustment Documentation
AMA CPT 2026 Professional Edition (2026); AAPC Codify, CPT Code 31300, verified current for 2026 (2026); CMS CY2026 Medicare Physician Fee Schedule Final Rule, CMS-1832-F (2026); CMS RVU26 Relative Value Files (2026) — wRVU flagged for confirmation; CMS National Correct Coding Initiative Policy Manual, Chapter 5 (2026); ICD-10-CM Official Guidelines for Coding and Reporting, FY2026; ICD-10-PCS Official Guidelines for Coding and Reporting, FY2026; CMS-HCC Risk Adjustment Model, Version 28 (2026) — HCC mapping flagged for confirmation