CPT code 31634: Bronchoscopy, balloon occlusion for air leak2026 Medicare rate & RVUs in California
Bronchoscopic balloon occlusion temporarily blocks selected airways to help locate and measure a persistent pulmonary air leak.
Medicare pays $1,744.06–$2,264.73 for 31634 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 8 sections
What 31634 covers
During this procedure, a pulmonologist or other bronchoscopist passes a flexible or rigid bronchoscope into the airways and uses a balloon catheter to temporarily occlude selected branches. The clinician observes the effect on an air leak, often through a connected chest drainage system, to help identify the airway responsible. This assessment may be used when a patient has a persistent leak, such as after lung surgery or with a bronchopleural fistula, and localization could guide treatment planning.
Report the service when balloon occlusion and air-leak assessment are performed, rather than for airway inspection alone or airway dilation. The record should support the clinical reason for testing, the airways occluded, and the observed leak response or measurements. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. CMS may pay for an assistant at surgery; 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.
Where 31634 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$1744.06 to $2264.73
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $1,745.18 | $171.43 |
| Chico, CA | $1,744.06 | $170.31 |
| El Centro, CA | $1,744.12 | $170.37 |
| Fresno, CA | $1,744.06 | $170.31 |
| Hanford, CA | $1,744.06 | $170.31 |
| Los Angeles, CA | $1,876.59 | $177.92 |
| Madera, CA | $1,744.06 | $170.31 |
| Marin County, CA | $2,214.87 | $190.24 |
| Merced, CA | $1,744.06 | $170.31 |
| Modesto, CA | $1,744.06 | $170.31 |
| Napa, CA | $2,076.12 | $183.60 |
| Oxnard, CA | $1,873.04 | $175.80 |
| Redding, CA | $1,744.06 | $170.31 |
| Rest of California | $1,744.06 | $170.31 |
| Riverside, CA | $1,747.99 | $174.24 |
| Sacramento, CA | $1,845.00 | $175.05 |
| Salinas, CA | $1,838.50 | $174.29 |
| San Benito County, CA | $2,264.73 | $194.16 |
| San Diego, CA | $1,892.92 | $175.58 |
| San Francisco, CA | $2,214.46 | $189.83 |
| San Luis Obispo, CA | $1,807.35 | $171.86 |
| Santa Clara County, CA | $2,263.06 | $192.49 |
| Santa Cruz, CA | $1,919.71 | $175.09 |
| Santa Maria, CA | $1,848.44 | $174.18 |
| Santa Rosa, CA | $1,939.95 | $176.66 |
| Stockton, CA | $1,744.06 | $170.31 |
| Vallejo, CA | $2,075.53 | $183.01 |
| Visalia, CA | $1,744.06 | $170.31 |
| Yuba City, CA | $1,744.06 | $170.31 |
How the 31634 rate is calculated
Each of 31634’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 · 31634
RVUs × geographic indexes × conversion factor
Work3.66
3.66 RVUs× 1.000 GPCI
Practice expense44.07
44.07 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
48.0900
Conversion factor
$33.4009
Medicare rate
$1,606.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31634
The CMS indicators that decide how 31634 is paid alongside other services.
CMS payment indicators · 31634
Bronchoscopy, balloon occlusion for air leak
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
31634 without 51 · national office
$1,606.25
Bronchoscopy, balloon occlusion for air leak
31634-51 · Second procedure: 50%
$803.13
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%).
31634 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 31622BronchoscopyDiagnostic with washing
- This is diagnostic bronchoscopy without the balloon-occlusion air-leak assessment that distinguishes 31634.
- 31630BronchoscopyAirway dilation without stent
- 31630 addresses bronchial dilation for narrowing; 31634 uses temporary balloon occlusion to assess an air leak.
- 31631Airway stentTracheal stent placement
- 31631 involves airway dilation with stent placement, not balloon occlusion to localize an air leak.
- 31643BronchoscopyRadiopharmaceutical delivery catheter
- 31643 describes bronchoscopic catheter placement for radiologic or therapeutic purposes; 31634 is specific to balloon-occlusion air-leak assessment.
31634 billing questions
When is 31634 more appropriate than a diagnostic bronchoscopy code?
Use 31634 when balloon occlusion is performed to assess an air leak. Airway inspection without that assessment is a different service.
What documentation supports reporting 31634?
Document the indication for air-leak localization, the airway branches occluded, and the leak response or measurements observed during the test.
Can modifier 50 be used when both lungs are assessed?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does CMS price related endoscopies performed in the same session?
Endoscopy family pricing applies when related endoscopies are performed together.
Can an assistant, co-surgeon, or surgical team be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included in the procedure.
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
Fee sheets · Coming soon
Put 31634 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist