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

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 Puerto Rico, Medicare pays $86.54 for 31633 in the office and $56.15 when it’s performed in a hospital or facility.

$86.54Office (non-facility)
$56.15Hospital or facility
+0.4%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $86.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

31633 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$86.54
  2. Los Angeles, CA · California$93.75+$7.21
  3. Washington, DC area · District of Columbia$95.91+$9.37
  4. Miami, FL · Florida$93.90+$7.36
  5. Chicago, IL · Illinois$91.86+$5.32
  6. Manhattan, NY · New York$97.61+$11.07
  7. Alaska · Alaska$108.46+$21.92

Other areas in Puerto Rico 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.

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.

$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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 31633 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.29× 1.0001.2900
Practice expense1.17× 1.0111.1829
Malpractice0.12× 0.9850.1182
Total RVUs2.5911
Conversion factor× 33.4009

Office rate, Puerto Rico$86.54

Office: (1.29 × 1 + 1.17 × 1.011 + 0.12 × 0.985) × $33.4009 = $86.54

Facility: (1.29 × 1 + 0.27 × 1.011 + 0.12 × 0.985) × $33.4009 = $56.15

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.

Codes related to 31633

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

Codes related to 31633
CodeHow it relatesOffice range, Puerto Rico
Primary code
31629Bronchoscopic biopsy, needle aspiration biopsyPrimary bronchoscopic transbronchial needle aspiration biopsy code paired with 31633.$500.82
Same family
31632Lung biopsy, each additional lobeAdditional-lobe add-on for bronchoscopic transbronchial lung biopsy.$69.13
Used instead
31628Lung biopsy, single lobePrimary bronchoscopic transbronchial lung biopsy code for a different sampling technique.$411.43
31625Bronchoscopy biopsy, airway tissue samplingBronchoscopic biopsy code for airway tissue sampling rather than additional-lobe needle aspiration.$386.96

How 31633 has changed in Puerto Rico

31633 · Office / nonfacility

$86.54

Effective 2026-10-01

The base rate is $8.44 higher than on 2025-10-01, moving from $78.10 to $86.54 (10.8%).

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

    $78.10changed to$86.54

    • 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 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $80.03changed to$78.10

    • 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

    $78.73changed to$80.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $80.50changed to$78.73

    • 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 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $80.31changed to$80.50

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $82.57changed to$80.31

    • 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 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $82.55changed to$82.57

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

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $81.77changed to$82.55

    • 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 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $81.98changed to$81.77

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $82.62changed to$81.98

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

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $76.33changed to$82.62

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $78.71changed to$76.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.20 changed to 0.86
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $75.95changed to$78.71

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

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $75.57changed to$75.95

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $75.03changed to$75.57

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $73.90changed to$75.03

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.22 changed to 1.08
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $73.90

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$86.54$56.15RVU26D
2026-07-01$86.54$56.15RVU26C
2026-04-01$86.54$56.15RVU26B
2026-01-01$86.54$56.15RVU26A
2025-10-01$78.10$59.86RVU25D
2025-07-01$78.10$59.86RVU25C
2025-04-01$78.10$59.86RVU25B
2025-01-01$78.10$59.86RVU25A
2024-10-01$80.03$61.26RVU24D
2024-07-01$80.03$61.26RVU24C
2024-04-01$80.03$61.26RVU24B
2024-03-09$80.03$61.26RVU24AR
2024-01-01$78.73$60.26RVU24A
2023-10-01$80.50$62.05RVU23D
2023-07-01$80.31$62.01RVU23C
2023-04-01$80.31$62.01RVU23B
2023-01-01$80.31$62.01RVU23A
2022-10-01$82.57$63.74RVU22D
2022-07-01$82.57$63.74RVU22C
2022-04-01$82.57$63.74RVU22B
2022-01-01$82.57$63.74RVU22A
2021-10-01$82.55$64.62RVU21D
2021-07-01$82.55$64.62RVU21C
2021-04-01$82.55$64.62RVU21B
2021-01-01$82.55$64.62RVU21A
2020-10-01$81.77$65.76RVU20D
2020-07-01$81.77$65.76RVU20C
2020-04-01$81.77$65.76RVU20B
2020-01-01$81.77$65.76RVU20A
2019-10-01$81.98$66.01RVU19D
2019-07-01$81.98$66.01RVU19C
2019-04-01$81.98$66.01RVU19B
2019-01-01$81.98$66.01RVU19A
2018-10-01$82.62$65.94RVU18D
2018-07-01$82.62$65.94RVU18C
2018-04-01$82.62$65.94RVU18B
2018-01-01$82.62$65.94RVU18AR1
2017-10-01$76.33$62.20RVU17D
2017-07-01$76.33$62.20RVU17C
2017-04-01$76.33$62.20RVU17B
2017-01-01$76.33$62.20RVU17A
2016-10-01$78.71$58.51RVU16D
2016-07-01$78.71$58.51RVU16C
2016-04-01$78.71$58.51RVU16B
2016-01-01$78.71$58.51RVU16A
2015-10-01$75.95$58.72RVU15D
2015-07-01$75.95$58.72RVU15C
2015-04-01$75.57$58.43RVU15B
2015-01-01$75.57$58.43RVU15A
2014-10-01$75.03$58.17RVU14D
2014-07-01$75.03$58.17RVU14C
2014-04-01$75.03$58.17RVU14B
2014-01-01$75.03$58.17RVU14A
2013-10-01$73.90$56.14RVU13D
2013-07-01$73.90$56.14RVU13C
2013-04-01$73.90$56.14RVU13B
2013-01-01$73.90$56.14RVU13AR

Price 31633 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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