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

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 Iowa, Medicare pays $80.44 for 31633 in the office and $52.93 when it’s performed in a hospital or facility.

$80.44Office (non-facility)
$52.93Hospital or facility
−6.6%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 Iowa
  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 Iowa 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. Iowa pays $80.44. The RVUs are the same everywhere; the geographic indexes change the dollars.

31633 in Iowa vs other payment areas
  1. Iowa · this page$80.44
  2. Los Angeles, CA · California$93.75+$13.31
  3. Washington, DC area · District of Columbia$95.91+$15.47
  4. Miami, FL · Florida$93.90+$13.46
  5. Chicago, IL · Illinois$91.86+$11.42
  6. Manhattan, NY · New York$97.61+$17.17
  7. Alaska · Alaska$108.46+$28.02

Other areas in Iowa 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 Iowa 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

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 31633 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.29× 1.0001.2900
Practice expense1.17× 0.9151.0705
Malpractice0.12× 0.3970.0476
Total RVUs2.4082
Conversion factor× 33.4009

Office rate, Iowa$80.44

Office: (1.29 × 1 + 1.17 × 0.915 + 0.12 × 0.397) × $33.4009 = $80.44

Facility: (1.29 × 1 + 0.27 × 0.915 + 0.12 × 0.397) × $33.4009 = $52.93

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 Iowa

31633 · Office / nonfacility

$80.44

Effective 2026-10-01

The base rate is $7.47 higher than on 2025-10-01, moving from $72.97 to $80.44 (10.2%).

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

    $72.97changed to$80.44

    • 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 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $74.79changed to$72.97

    • 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

    $73.57changed to$74.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $75.20changed to$73.57

    • 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
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $77.12changed to$75.20

    • 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
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $77.12changed to$77.12

    • 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

    $76.84changed to$77.12

    • 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
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $76.71changed to$76.84

    • 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
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $77.27changed to$76.71

    • 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

    $77.02changed to$77.27

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $87.70changed to$77.02

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.20 changed to 0.86
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $84.15changed to$87.70

    • 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

    $83.73changed to$84.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $83.50changed to$83.73

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $83.28changed to$83.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.22 changed to 1.08
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $83.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$80.44$52.93RVU26D
2026-07-01$80.44$52.93RVU26C
2026-04-01$80.44$52.93RVU26B
2026-01-01$80.44$52.93RVU26A
2025-10-01$72.97$56.43RVU25D
2025-07-01$72.97$56.43RVU25C
2025-04-01$72.97$56.43RVU25B
2025-01-01$72.97$56.43RVU25A
2024-10-01$74.79$57.77RVU24D
2024-07-01$74.79$57.77RVU24C
2024-04-01$74.79$57.77RVU24B
2024-03-09$74.79$57.77RVU24AR
2024-01-01$73.57$56.83RVU24A
2023-10-01$75.20$58.55RVU23D
2023-07-01$75.20$58.55RVU23C
2023-04-01$75.20$58.55RVU23B
2023-01-01$75.20$58.55RVU23A
2022-10-01$77.12$60.17RVU22D
2022-07-01$77.12$60.17RVU22C
2022-04-01$77.12$60.17RVU22B
2022-01-01$77.12$60.17RVU22A
2021-10-01$77.12$60.98RVU21D
2021-07-01$77.12$60.98RVU21C
2021-04-01$77.12$60.98RVU21B
2021-01-01$77.12$60.98RVU21A
2020-10-01$76.84$62.44RVU20D
2020-07-01$76.84$62.44RVU20C
2020-04-01$76.84$62.44RVU20B
2020-01-01$76.84$62.44RVU20A
2019-10-01$76.71$62.32RVU19D
2019-07-01$76.71$62.32RVU19C
2019-04-01$76.71$62.32RVU19B
2019-01-01$76.71$62.32RVU19A
2018-10-01$77.27$62.26RVU18D
2018-07-01$77.27$62.26RVU18C
2018-04-01$77.27$62.26RVU18B
2018-01-01$77.27$62.26RVU18AR1
2017-10-01$77.02$62.13RVU17D
2017-07-01$77.02$62.13RVU17C
2017-04-01$77.02$62.13RVU17B
2017-01-01$77.02$62.13RVU17A
2016-10-01$87.70$62.04RVU16D
2016-07-01$87.70$62.04RVU16C
2016-04-01$87.70$62.04RVU16B
2016-01-01$87.70$62.04RVU16A
2015-10-01$84.15$62.26RVU15D
2015-07-01$84.15$62.26RVU15C
2015-04-01$83.73$61.95RVU15B
2015-01-01$83.73$61.95RVU15A
2014-10-01$83.50$61.77RVU14D
2014-07-01$83.50$61.77RVU14C
2014-04-01$83.50$61.77RVU14B
2014-01-01$83.50$61.77RVU14A
2013-10-01$83.28$60.04RVU13D
2013-07-01$83.28$60.04RVU13C
2013-04-01$83.28$60.04RVU13B
2013-01-01$83.28$60.04RVU13AR

Price 31633 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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 IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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