CPT code 31641: Therapeutic bronchoscopy, tumor destruction or stenosis relief2026 Medicare rate & RVUs in Guam
Report this therapeutic bronchoscopy for destruction of an airway tumor or relief of stenosis using a method other than excision.
CMS doesn’t publish an office rate for 31641 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 31641 covers
This service treats an obstructing endobronchial tumor or narrowed airway through a rigid or flexible bronchoscope, using a destructive technique rather than excision. A pulmonologist, interventional pulmonologist, or thoracic surgeon may use methods such as laser treatment, thermal ablation, or cryotherapy to restore airway patency. It is commonly performed in a hospital or other procedural setting for malignant or benign airway obstruction.
Select the code when the documented treatment destroys tumor or relieves stenosis without removing the tissue by excision; use the operative report to identify the airway site, obstruction, and technique. 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, and no bilateral adjustment applies. Medicare does not pay an assistant at surgery for this service; 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.
31641 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $223.70 |
How the 31641 rate is calculated
Each of 31641’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 · 31641
RVUs × geographic indexes × conversion factor
Work4.89
4.89 RVUs× 1.000 GPCI
Practice expense1.34
1.34 RVUs× 1.000 GPCI
Malpractice0.49
0.49 RVUs× 1.000 GPCI
Adjusted RVUs
6.7200
Conversion factor
$33.4009
Medicare rate
$224.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31641
The CMS indicators that decide how 31641 is paid alongside other services.
CMS payment indicators · 31641
Therapeutic bronchoscopy, tumor destruction or stenosis relief
| 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) | 1 | Not paid (statutory restriction). |
| 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
31641 without 51 · national facility
$224.45
Therapeutic bronchoscopy, tumor destruction or stenosis relief
31641-51 · Second procedure: 50%
$112.23
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%).
31641 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31640Bronchoscopic tumor removalEndobronchial excision
- Choose 31640 when the bronchoscopic tumor treatment removes tissue by excision. Choose 31641 for tumor destruction or stenosis relief without excision.
- 31630BronchoscopyAirway dilation without stent
- 31630 describes bronchoscopic dilation of an airway. This code describes tumor destruction or stenosis relief by a method other than excision.
- 31631Airway stentTracheal stent placement
- 31631 is used when bronchoscopic dilation includes stent placement. This code is for non-excisional tumor destruction or stenosis relief, not stent placement.
31641 billing questions
When should this code be chosen over 31640?
Use this code when the airway tumor is destroyed or stenosis is relieved without excision. Code 31640 describes bronchoscopic tumor excision.
How does this differ from bronchoscopic dilation?
This code represents tumor destruction or stenosis relief by a method other than excision. Codes 31630 and 31631 describe dilation, with 31631 involving stent placement.
What documentation supports reporting this service?
Document the airway location and obstruction, the therapeutic method, and how the procedure treated the tumor or stenosis. The record should distinguish destruction or non-excisional stenosis relief from tissue excision.
Can modifier 50 be reported?
No. CMS does not apply a bilateral adjustment, and modifier 50 is inappropriate for this bronchoscopic service.
What happens when related endoscopies are performed in the same session?
CMS applies endoscopy-family pricing when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
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
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