CPT code 31625: Bronchoscopy biopsy, airway tissue sampling2026 Medicare rate & RVUs in Texas

Reports bronchoscopic tissue sampling from an airway lesion or abnormal mucosa, such as when a pulmonologist biopsies a suspicious endobronchial finding.

CMS RVU26DEffective Oct 1, 20268 payment localities12.4K Medicare services in 2024

Medicare pays $358.84–$399.00 for 31625 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.

$358.84–$399.00Office (non-facility)
$137.26–$144.99Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Texas
  2. What 31625 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 31625 covers

A pulmonologist or other qualified physician passes a bronchoscope into the airways and obtains tissue from an abnormal area, commonly with biopsy forceps. Typical targets include a visible bronchial mass, irregular mucosa, or another airway lesion requiring histologic evaluation. The procedure is commonly performed in a hospital bronchoscopy suite or an outpatient procedural setting, with sedation or anesthesia as clinically appropriate.

Choose this code for biopsy of airway tissue; transbronchial sampling of lung parenchyma is represented by a different code. The report should identify the biopsy site and describe the abnormality sampled and the tissue obtained. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed in the same session, endoscopy-family pricing applies. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 31625 pays more and less in Texas

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

8 payment localities

$358.84 to $399.00

$358.84$378.92$399.00
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

8 of 8 payment localities

31625 office and facility rates by payment locality
Payment localityOfficeFacility
Austin, TX$399.00$141.38
Beaumont, TX$358.84$137.26
Brazoria, TX$380.26$138.96
Dallas, TX$382.51$139.99
Fort Worth, TX$379.91$139.82
Galveston, TX$381.29$139.50
Houston, TX$386.78$144.99
Rest of Texas$369.22$138.15

How the 31625 rate is calculated

Each of 31625’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 31625

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.03

3.03 RVUs× 1.000 GPCI

Practice expense8.17

8.17 RVUs× 1.000 GPCI

Malpractice0.30

0.30 RVUs× 1.000 GPCI

Adjusted RVUs

11.5000

Conversion factor

$33.4009

Medicare rate

$384.11

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 31625

The CMS indicators that decide how 31625 is paid alongside other services.

CMS payment indicators · 31625

Bronchoscopy biopsy, airway tissue sampling

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

31625 without 51 · national office

$384.11

Bronchoscopy biopsy, airway tissue sampling

31625-51 · Second procedure: 50%

$192.06

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

31625 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 31625

    Bronchoscopy biopsy, airway tissue sampling3.03 wRVU

    $384.11

  • 31628

    Lung biopsy, single lobe3.46 wRVU

    $408.49+$24.38

  • 31622

    Bronchoscopy, diagnostic with washing2.47 wRVU

    $282.24−$101.87

  • 31623

    Bronchoscopy, brush cytology2.56 wRVU

    $302.95−$81.16

  • 31629

    Bronchoscopic biopsy, needle aspiration biopsy3.66 wRVU

    $497.01+$112.90

How to choose

31628Lung biopsySingle lobe
The biopsy target determines the choice: 31625 is for airway tissue, while 31628 is for transbronchial lung tissue.
31622BronchoscopyDiagnostic with washing
31622 describes diagnostic bronchoscopy without the airway tissue biopsy reported with 31625.
31623BronchoscopyBrush cytology
31623 collects cells by brushing; 31625 obtains tissue from an airway abnormality.
31629Bronchoscopic biopsyNeedle aspiration biopsy
31629 describes needle aspiration sampling, rather than the airway tissue biopsy reported with 31625.

31625 billing questions

When should this code be chosen instead of 31628?

Use this code for tissue taken from an airway lesion or mucosa. Code 31628 applies to transbronchial biopsy of lung tissue.

Can diagnostic bronchoscopy also be reported?

The airway inspection needed to locate and obtain the biopsy is part of the biopsy service. CMS endoscopy-family pricing applies when related endoscopies are performed together.

What documentation supports the biopsy?

Document the airway site, the abnormal finding sampled, and that tissue was obtained for evaluation. Distinguish an airway biopsy from sampling of lung parenchyma.

Should modifier 50 be appended for biopsies on both sides?

No. CMS identifies bilateral adjustment as inapplicable because the code descriptor or anatomy makes modifier 50 inappropriate.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 31625PPRRVU2026_Oct_nonQPP.csv, line 3,634 (RVU26D)

Open CMS sourceHow we calculate rates

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