CPT code 31633: Bronchoscopic needle biopsy, each additional lobe2026 Medicare rate & RVUs in Hawaii, Guam, HI

Reports needle aspiration biopsy during bronchoscopy when the physician samples an additional lung lobe beyond the lobe represented by the primary procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality2.8K Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $89.84 for 31633 in the office and $55.66 when it’s performed in a hospital or facility.

$89.84Office (non-facility)
$55.66Hospital or facility
+4.3%vs the national office rate ($86.17)

Check a contract rate as a % of Medicare · 31633 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 31633 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 31633 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 31633 covers

This add-on describes bronchoscopic transbronchial needle aspiration biopsy in an additional lung lobe. A pulmonologist or other qualified physician performs the sampling through a flexible or rigid bronchoscope, commonly during diagnostic evaluation of a suspected pulmonary lesion. The needle passes through the airway wall to obtain tissue or cells from the targeted site. The code distinguishes sampling in another lobe from additional needle passes or specimens taken in the same lobe.

Report 31633 with the primary bronchoscopic needle aspiration procedure, 31629, when documentation supports sampling in an additional lobe. Record the lobes sampled and the bronchoscopic needle-biopsy technique so the additional-lobe service is clear. CMS identifies 31633 as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period.

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 Hawaii, Guam, HI compares for 31633

Across 109 of 109 payment localities, the office rate for 31633 runs from $78.72 in Arkansas to $108.46 in Alaska. Hawaii, Guam, HI pays $89.84. The RVUs are the same everywhere; the geographic indexes change the dollars.

31633 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$89.84
  2. Los Angeles, CA · California$93.75+$3.91
  3. Washington, DC area · District of Columbia$95.91+$6.07
  4. Miami, FL · Florida$93.90+$4.06
  5. Chicago, IL · Illinois$91.86+$2.02
  6. Manhattan, NY · New York$97.61+$7.77
  7. Alaska · Alaska$108.46+$18.62

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

Every other payment area

31633 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$79.55$53.25
ArkansasArkansas$78.72$52.90
ArizonaArizona$84.39$55.26
Bakersfield, CACalifornia$89.18$56.23
Chico, CACalifornia$88.80$55.85
El Centro, CACalifornia$88.82$55.87
Fresno, CACalifornia$88.80$55.85
Hanford, CACalifornia$88.80$55.85

31633 rates by state

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

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.

$78.72

$108.46

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

View every state and territory as a table
31633 office rate range by state
State / territoryOffice rate rangeLocalities
AK$108.461
AL$79.551
AR$78.721
AZ$84.391
CA$88.80–$106.3329
CO$88.311
CT$90.891
DC$95.911
DE$85.521
FL$86.47–$93.903
GA$82.72–$87.732
GU$89.841
HI$89.841
IA$80.441
ID$80.941
IL$85.03–$91.864
IN$81.261
KS$80.431
KY$81.501
LA$81.51–$84.412
MA$88.12–$95.082
MD$86.75–$95.913
ME$81.53–$84.342
MI$83.29–$87.562
MN$84.491
MO$80.68–$84.313
MS$79.701
MT$86.171
NC$82.111
ND$83.791
NE$80.671
NH$87.281
NJ$91.88–$95.412
NM$83.741
NV$85.541
NY$83.03–$99.755
OH$82.811
OK$81.101
OR$84.83–$90.182
PA$82.75–$89.332
PR$86.541
RI$87.851
SC$82.601
SD$83.511
TN$80.761
TX$82.37–$88.078
UT$83.421
VA$84.33–$95.912
VI$86.541
VT$83.801
WA$87.85–$96.472
WI$81.761
WV$82.781
WY$85.131

See 31633 in every payment locality

How the 31633 rate is calculated

Each of 31633’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 · 31633

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.29

1.29 RVUs× 1.000 GPCI

Practice expense1.17

1.17 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

2.5800

Conversion factor

$33.4009

Medicare rate

$86.17

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

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,642

Code
31633
Physician work
1.29
Practice expense
1.17
Malpractice
0.12

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 31633 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work1.29× 1.0001.2900
Practice expense1.17× 1.1371.3303
Malpractice0.12× 0.5790.0695
Total RVUs2.6898
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$89.84

Office: (1.29 × 1 + 1.17 × 1.137 + 0.12 × 0.579) × $33.4009 = $89.84

Facility: (1.29 × 1 + 0.27 × 1.137 + 0.12 × 0.579) × $33.4009 = $55.66

Open 31633 in the RVU calculator

Payment rules and modifiers for 31633

The CMS indicators that decide how 31633 is paid alongside other services.

CMS payment indicators · 31633

Bronchoscopic needle biopsy, each additional lobe

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

How 31633 has changed in Hawaii, Guam, HI

31633 · Office / nonfacility

$89.84

Effective 2026-10-01

The base rate is $9.10 higher than on 2025-10-01, moving from $80.74 to $89.84 (11.3%).

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

    $80.74changed to$89.84

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.32 changed to 1.29
    • Practice expense RVU 0.96 changed to 1.17
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $82.70changed to$80.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.95 changed to 0.96

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $81.35changed to$82.70

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $83.49changed to$81.35

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.93 changed to 0.95
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561
  5. January 1, 2023

    RVU23A

    $86.28changed to$83.49

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.95 changed to 0.93
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $86.20changed to$86.28

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.93 changed to 0.95

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $85.11changed to$86.20

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.85 changed to 0.93
    • Malpractice RVU 0.09 changed to 0.11
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $84.75changed to$85.11

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.84 changed to 0.85
    • Malpractice RVU 0.11 changed to 0.09
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $85.48changed to$84.75

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.86 changed to 0.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $85.52changed to$85.48

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $99.76changed to$85.52

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.20 changed to 0.86
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $95.11changed to$99.76

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.08 changed to 1.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $94.64changed to$95.11

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $94.54changed to$94.64

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.10 changed to 0.11
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $95.19changed to$94.54

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.22 changed to 1.08
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$95.19

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$89.84$55.66RVU26D
2026-07-01$89.84$55.66RVU26C
2026-04-01$89.84$55.66RVU26B
2026-01-01$89.84$55.66RVU26A
2025-10-01$80.74$59.92RVU25D
2025-07-01$80.74$59.92RVU25C
2025-04-01$80.74$59.92RVU25B
2025-01-01$80.74$59.92RVU25A
2024-10-01$82.70$61.28RVU24D
2024-07-01$82.70$61.28RVU24C
2024-04-01$82.70$61.28RVU24B
2024-03-09$82.70$61.28RVU24AR
2024-01-01$81.35$60.28RVU24A
2023-10-01$83.49$62.52RVU23D
2023-07-01$83.49$62.52RVU23C
2023-04-01$83.49$62.52RVU23B
2023-01-01$83.49$62.52RVU23A
2022-10-01$86.28$64.92RVU22D
2022-07-01$86.28$64.92RVU22C
2022-04-01$86.28$64.92RVU22B
2022-01-01$86.28$64.92RVU22A
2021-10-01$86.20$65.86RVU21D
2021-07-01$86.20$65.86RVU21C
2021-04-01$86.20$65.86RVU21B
2021-01-01$86.20$65.86RVU21A
2020-10-01$85.11$66.94RVU20D
2020-07-01$85.11$66.94RVU20C
2020-04-01$85.11$66.94RVU20B
2020-01-01$85.11$66.94RVU20A
2019-10-01$84.75$66.57RVU19D
2019-07-01$84.75$66.57RVU19C
2019-04-01$84.75$66.57RVU19B
2019-01-01$84.75$66.57RVU19A
2018-10-01$85.48$66.50RVU18D
2018-07-01$85.48$66.50RVU18C
2018-04-01$85.48$66.50RVU18B
2018-01-01$85.48$66.50RVU18AR1
2017-10-01$85.52$66.47RVU17D
2017-07-01$85.52$66.47RVU17C
2017-04-01$85.52$66.47RVU17B
2017-01-01$85.52$66.47RVU17A
2016-10-01$99.76$66.48RVU16D
2016-07-01$99.76$66.48RVU16C
2016-04-01$99.76$66.48RVU16B
2016-01-01$99.76$66.48RVU16A
2015-10-01$95.11$66.72RVU15D
2015-07-01$95.11$66.72RVU15C
2015-04-01$94.64$66.39RVU15B
2015-01-01$94.64$66.39RVU15A
2014-10-01$94.54$66.33RVU14D
2014-07-01$94.54$66.33RVU14C
2014-04-01$94.54$66.33RVU14B
2014-01-01$94.54$66.33RVU14A
2013-10-01$95.19$64.96RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 31633 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

31633 billing questions

Which primary procedure must accompany 31633?

Report 31633 with 31629, the primary code for bronchoscopic transbronchial needle aspiration biopsy. The record should identify the additional lobe sampled.

Does each additional needle pass support another unit?

No. The add-on is based on sampling an additional lobe, not on the number of needle passes or specimens from the same lobe.

How is 31633 different from 31632?

31633 represents needle aspiration biopsy in an additional lobe. 31632 represents additional-lobe transbronchial lung biopsy, a different sampling technique.

What documentation supports the add-on?

Document the primary needle aspiration procedure, the lobe or lobes sampled, and the needle-biopsy method. The record should distinguish the additional lobe from the lobe represented by the primary service.

Can 31633 be reported by itself?

No. CMS classifies it as an add-on code that must be billed with a primary procedure; its payment is within that procedure's global period.

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 31633PPRRVU2026_Oct_nonQPP.csv, line 3,642 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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