FeeBase
Log inGet started
Menu

CPT code 31628: Lung biopsy, single lobe2026 Medicare rate & RVUs in South Carolina

Report this bronchoscopy when transbronchial lung tissue is sampled from one lobe; use the companion add-on code for each additional lobe.

CMS RVU26DEffective Oct 1, 2026One payment locality43.3K Medicare services in 2024

In South Carolina, Medicare pays $385.41 for 31628 in the office and $154.56 when it’s performed in a hospital or facility.

$385.41Office (non-facility)
$154.56Hospital or facility
−5.7%vs the national office rate ($408.49)

Check a contract rate as a % of Medicare · 31628 nationwide

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

We’ll open 31628 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 31628 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 31628 covers

A pulmonologist or interventional pulmonologist passes a bronchoscope into the airways and obtains lung tissue through the bronchial wall, typically with biopsy forceps. The code represents sampling from one lobe during a diagnostic evaluation, such as investigating diffuse lung disease, infection, or a suspected pulmonary lesion. The procedure is commonly performed in a hospital or ambulatory surgery setting; imaging guidance may be used.

Choose this code based on the transbronchial biopsy method and one lobe sampled, not the number of tissue fragments. Record the biopsy technique, sampled lobe, and findings; report 31632 for each additional lobe sampled in the same session. When related endoscopies are performed together, CMS applies endoscopy family pricing. The 0-day global period includes same-day preoperative and postoperative care. Bilateral adjustment is inappropriate. Medicare does not pay an assistant at surgery for this service, 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.

How South Carolina compares for 31628

Across 109 of 109 payment localities, the office rate for 31628 runs from $363.40 in Arkansas to $540.69 in San Benito County, CA. South Carolina pays $385.41. The RVUs are the same everywhere; the geographic indexes change the dollars.

31628 in South Carolina vs other payment areas
  1. South Carolina · this page$385.41
  2. Los Angeles, CA · California$461.12+$75.71
  3. Washington, DC area · District of Columbia$466.16+$80.75
  4. Miami, FL · Florida$436.90+$51.49
  5. Chicago, IL · Illinois$424.99+$39.58
  6. Manhattan, NY · New York$468.02+$82.61
  7. Alaska · Alaska$479.65+$94.24

Other areas in South Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

31628 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$368.47$149.86
ArkansasArkansas$363.40$148.79
ArizonaArizona$398.17$156.07
Bakersfield, CACalifornia$433.44$159.62
Chico, CACalifornia$432.41$158.58
El Centro, CACalifornia$432.46$158.64
Fresno, CACalifornia$432.41$158.58
Hanford, CACalifornia$432.41$158.58

31628 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$363.40

$486.55

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
31628 office rate range by state
State / territoryOffice rate rangeLocalities
AK$479.651
AL$368.471
AR$363.401
AZ$398.171
CA$432.41–$540.6929
CO$425.511
CT$434.831
DC$466.161
DE$404.571
FL$401.63–$436.903
GA$380.16–$415.572
GU$442.471
HI$442.471
IA$377.881
ID$380.131
IL$390.17–$425.424
IN$382.251
KS$375.961
KY$376.261
LA$375.61–$393.362
MA$423.05–$466.712
MD$412.13–$466.163
ME$381.77–$401.892
MI$385.39–$406.192
MN$408.911
MO$369.30–$394.983
MS$366.431
MT$408.471
NC$385.631
ND$401.951
NE$379.931
NH$418.671
NJ$440.12–$461.632
NM$387.311
NV$406.931
NY$391.12–$478.625
OH$384.061
OK$375.871
OR$404.09–$438.812
PA$384.77–$424.262
PR$411.431
RI$418.801
SC$385.411
SD$401.171
TN$377.741
TX$382.34–$423.828
UT$390.451
VA$400.46–$466.162
VI$411.431
VT$400.231
WA$422.30–$476.252
WI$389.031
WV$376.311
WY$405.631

See 31628 in every payment locality

How the 31628 rate is calculated

Each of 31628’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 · 31628

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.46

3.46 RVUs× 1.000 GPCI

Practice expense8.44

8.44 RVUs× 1.000 GPCI

Malpractice0.33

0.33 RVUs× 1.000 GPCI

Adjusted RVUs

12.2300

Conversion factor

$33.4009

Medicare rate

$408.49

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

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,637

Code
31628
Physician work
3.46
Practice expense
8.44
Malpractice
0.33

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 31628 in South Carolina
ComponentRVULocality factorAdjusted
Physician work3.46× 1.0003.4600
Practice expense8.44× 0.9247.7986
Malpractice0.33× 0.8500.2805
Total RVUs11.5391
Conversion factor× 33.4009

Office rate, South Carolina$385.41

Office: (3.46 × 1 + 8.44 × 0.924 + 0.33 × 0.85) × $33.4009 = $385.41

Facility: (3.46 × 1 + 0.96 × 0.924 + 0.33 × 0.85) × $33.4009 = $154.56

Open 31628 in the RVU calculator

Payment rules and modifiers for 31628

The CMS indicators that decide how 31628 is paid alongside other services.

CMS payment indicators · 31628

Lung biopsy, single lobe

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

31628 without 51 · national office

$408.49

Lung biopsy, single lobe

31628-51 · Second procedure: 50%

$204.25

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

Codes related to 31628

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 31628
CodeHow it relatesOffice range, South Carolina
Add-on codes
31632Lung biopsy, each additional lobeAdd-on code for transbronchial lung biopsy in each additional lobe.$65.92
31627Navigational bronchoscopy, computer-assisted image guidanceNavigation add-on that may accompany bronchoscopy for targeting a pulmonary lesion.$1,071.99
Used instead
31625Bronchoscopy biopsy, airway tissue samplingBiopsy of an endobronchial site rather than lung parenchyma.$361.87
31629Bronchoscopic biopsy, needle aspiration biopsyUses transbronchial needle sampling rather than forceps lung biopsy.$467.63

How 31628 has changed in South Carolina

31628 · Office / nonfacility

$385.41

Effective 2026-10-01

The base rate is $52.06 higher than on 2025-10-01, moving from $333.35 to $385.41 (15.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $333.35changed to$385.41

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.55 changed to 3.46
    • Practice expense RVU 7.14 changed to 8.44
    • Malpractice RVU 0.29 changed to 0.33
    • Practice expense GPCI 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $346.94changed to$333.35

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.25 changed to 7.14
    • Malpractice RVU 0.31 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $341.28changed to$346.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $351.06changed to$341.28

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.30 changed to 0.31
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $363.33changed to$351.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.48 changed to 7.25
    • Malpractice RVU 0.28 changed to 0.30
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $362.39changed to$363.33

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.37 changed to 7.48
    • Malpractice RVU 0.26 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $349.58changed to$362.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.58 changed to 7.37
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $342.23changed to$349.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.35 changed to 6.58
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $337.46changed to$342.23

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.21 changed to 6.35
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $335.72changed to$337.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.17 changed to 6.21
    • Malpractice RVU 0.28 changed to 0.29
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $397.78changed to$335.72

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.80 changed to 3.55
    • Practice expense RVU 7.78 changed to 6.17
    • Malpractice RVU 0.30 changed to 0.28
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $357.20changed to$397.78

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.49 changed to 7.78
    • Malpractice RVU 0.31 changed to 0.30

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $355.42changed to$357.20

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $356.30changed to$355.42

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.55 changed to 6.49
    • Malpractice RVU 0.29 changed to 0.31
    • Practice expense GPCI 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $364.38changed to$356.30

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.43 changed to 6.55
    • Malpractice RVU 0.30 changed to 0.29
    • Practice expense GPCI 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $364.38

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$385.41$154.56RVU26D
2026-07-01$385.41$154.56RVU26C
2026-04-01$385.41$154.56RVU26B
2026-01-01$385.41$154.56RVU26A
2025-10-01$333.35$161.18RVU25D
2025-07-01$333.35$161.18RVU25C
2025-04-01$333.35$161.18RVU25B
2025-01-01$333.35$161.18RVU25A
2024-10-01$346.94$165.81RVU24D
2024-07-01$346.94$165.81RVU24C
2024-04-01$346.94$165.81RVU24B
2024-03-09$346.94$165.81RVU24AR
2024-01-01$341.28$163.10RVU24A
2023-10-01$351.06$167.06RVU23D
2023-07-01$351.06$167.06RVU23C
2023-04-01$351.06$167.06RVU23B
2023-01-01$351.06$167.06RVU23A
2022-10-01$363.33$170.21RVU22D
2022-07-01$363.33$170.21RVU22C
2022-04-01$363.33$170.21RVU22B
2022-01-01$363.33$170.21RVU22A
2021-10-01$362.39$171.14RVU21D
2021-07-01$362.39$171.14RVU21C
2021-04-01$362.39$171.14RVU21B
2021-01-01$362.39$171.14RVU21A
2020-10-01$349.58$174.79RVU20D
2020-07-01$349.58$174.79RVU20C
2020-04-01$349.58$174.79RVU20B
2020-01-01$349.58$174.79RVU20A
2019-10-01$342.23$173.95RVU19D
2019-07-01$342.23$173.95RVU19C
2019-04-01$342.23$173.95RVU19B
2019-01-01$342.23$173.95RVU19A
2018-10-01$337.46$174.61RVU18D
2018-07-01$337.46$174.61RVU18C
2018-04-01$337.46$174.61RVU18B
2018-01-01$337.46$174.61RVU18AR1
2017-10-01$335.72$175.02RVU17D
2017-07-01$335.72$175.02RVU17C
2017-04-01$335.72$175.02RVU17B
2017-01-01$335.72$175.02RVU17A
2016-10-01$397.78$187.17RVU16D
2016-07-01$397.78$187.17RVU16C
2016-04-01$397.78$187.17RVU16B
2016-01-01$397.78$187.17RVU16A
2015-10-01$357.20$189.41RVU15D
2015-07-01$357.20$189.41RVU15C
2015-04-01$355.42$188.47RVU15B
2015-01-01$355.42$188.47RVU15A
2014-10-01$356.30$187.58RVU14D
2014-07-01$356.30$187.58RVU14C
2014-04-01$356.30$187.58RVU14B
2014-01-01$356.30$187.58RVU14A
2013-10-01$364.38$182.22RVU13D
2013-07-01$364.38$182.22RVU13C
2013-04-01$364.38$182.22RVU13B
2013-01-01$364.38$182.22RVU13AR

Price 31628 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

31628 billing questions

How is this different from 31625?

31628 is for tissue sampled from lung parenchyma through the bronchial wall. Code 31625 describes biopsy of an endobronchial site, such as visible airway mucosa or a lesion within the bronchus.

Does the number of biopsy fragments change the code?

No. This code covers transbronchial lung biopsy in one lobe, regardless of the number of tissue fragments obtained. Use 31632 for each additional lobe sampled.

Can diagnostic bronchoscopy be reported separately?

The inspection needed to perform the biopsy is part of the bronchoscopy service. Do not separately report a diagnostic bronchoscopy for that same inspection during the biopsy session.

Should modifier 50 be used for biopsies in both lungs?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the lobes sampled, including the additional-lobe add-on when applicable.

What documentation supports reporting 31628 with 31632?

Document the transbronchial biopsy method and identify each lobe sampled. The record should support one lobe for 31628 and each additional lobe reported with 31632.

How does Medicare price this with another related endoscopy?

CMS applies endoscopy family pricing when related endoscopies are performed together. The 0-day global period includes same-day preoperative and postoperative care.

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 31628PPRRVU2026_Oct_nonQPP.csv, line 3,637 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 31628 pays in South Carolina?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 31628 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist