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

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 Virginia, Medicare pays $84.33 for 31633 in the office and $54.78 when it’s performed in a hospital or facility.

$84.33Office (non-facility)
$54.78Hospital or facility
−2.1%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 Virginia
  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 Virginia 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. Virginia pays $84.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

31633 in Virginia vs other payment areas
  1. Virginia · this page$84.33
  2. Los Angeles, CA · California$93.75+$9.42
  3. Washington, DC area · District of Columbia$95.91+$11.58
  4. Miami, FL · Florida$93.90+$9.57
  5. Chicago, IL · Illinois$91.86+$7.53
  6. Manhattan, NY · New York$97.61+$13.28
  7. Alaska · Alaska$108.46+$24.13

Other areas in Virginia 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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 31633 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.29× 1.0001.2900
Practice expense1.17× 0.9831.1501
Malpractice0.12× 0.7060.0847
Total RVUs2.5248
Conversion factor× 33.4009

Office rate, Virginia$84.33

Office: (1.29 × 1 + 1.17 × 0.983 + 0.12 × 0.706) × $33.4009 = $84.33

Facility: (1.29 × 1 + 0.27 × 0.983 + 0.12 × 0.706) × $33.4009 = $54.78

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 Virginia

31633 · Office / nonfacility

$84.33

Effective 2026-10-01

The base rate is $7.82 higher than on 2025-10-01, moving from $76.51 to $84.33 (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

    $76.51changed to$84.33

    • 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
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $78.41changed to$76.51

    • 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

    $77.13changed to$78.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $79.29changed to$77.13

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755
  5. January 1, 2023

    RVU23A

    $81.81changed to$79.29

    • 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 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $81.79changed to$81.81

    • 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

    $80.97changed to$81.79

    • 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
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $81.02changed to$80.97

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $81.64changed to$81.02

    • 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

    $81.19changed to$81.64

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $92.74changed to$81.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.20 changed to 0.86
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $88.84changed to$92.74

    • 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

    $88.40changed to$88.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $87.99changed to$88.40

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $87.95changed to$87.99

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.22 changed to 1.08
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $87.95

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$84.33$54.78RVU26D
2026-07-01$84.33$54.78RVU26C
2026-04-01$84.33$54.78RVU26B
2026-01-01$84.33$54.78RVU26A
2025-10-01$76.51$58.69RVU25D
2025-07-01$76.51$58.69RVU25C
2025-04-01$76.51$58.69RVU25B
2025-01-01$76.51$58.69RVU25A
2024-10-01$78.41$60.07RVU24D
2024-07-01$78.41$60.07RVU24C
2024-04-01$78.41$60.07RVU24B
2024-03-09$78.41$60.07RVU24AR
2024-01-01$77.13$59.09RVU24A
2023-10-01$79.29$61.17RVU23D
2023-07-01$79.29$61.17RVU23C
2023-04-01$79.29$61.17RVU23B
2023-01-01$79.29$61.17RVU23A
2022-10-01$81.81$63.21RVU22D
2022-07-01$81.81$63.21RVU22C
2022-04-01$81.81$63.21RVU22B
2022-01-01$81.81$63.21RVU22A
2021-10-01$81.79$64.08RVU21D
2021-07-01$81.79$64.08RVU21C
2021-04-01$81.79$64.08RVU21B
2021-01-01$81.79$64.08RVU21A
2020-10-01$80.97$65.23RVU20D
2020-07-01$80.97$65.23RVU20C
2020-04-01$80.97$65.23RVU20B
2020-01-01$80.97$65.23RVU20A
2019-10-01$81.02$65.39RVU19D
2019-07-01$81.02$65.39RVU19C
2019-04-01$81.02$65.39RVU19B
2019-01-01$81.02$65.39RVU19A
2018-10-01$81.64$65.31RVU18D
2018-07-01$81.64$65.31RVU18C
2018-04-01$81.64$65.31RVU18B
2018-01-01$81.64$65.31RVU18AR1
2017-10-01$81.19$64.93RVU17D
2017-07-01$81.19$64.93RVU17C
2017-04-01$81.19$64.93RVU17B
2017-01-01$81.19$64.93RVU17A
2016-10-01$92.74$64.59RVU16D
2016-07-01$92.74$64.59RVU16C
2016-04-01$92.74$64.59RVU16B
2016-01-01$92.74$64.59RVU16A
2015-10-01$88.84$64.82RVU15D
2015-07-01$88.84$64.82RVU15C
2015-04-01$88.40$64.50RVU15B
2015-01-01$88.40$64.50RVU15A
2014-10-01$87.99$64.12RVU14D
2014-07-01$87.99$64.12RVU14C
2014-04-01$87.99$64.12RVU14B
2014-01-01$87.99$64.12RVU14A
2013-10-01$87.95$62.36RVU13D
2013-07-01$87.95$62.36RVU13C
2013-04-01$87.95$62.36RVU13B
2013-01-01$87.95$62.36RVU13AR

Price 31633 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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