CPT code 31646: Bronchoscopic aspiration, subsequent aspiration2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $129.12 for 31646 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 31646 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 31646 covers

During bronchoscopy, the physician or other qualified practitioner uses suction through a flexible or rigid scope to clear additional secretions or mucus from the tracheobronchial tree. This may be needed when retained secretions or mucus plugging continue to obstruct the airways after an initial therapeutic aspiration. The service is commonly performed by a pulmonologist or thoracic surgeon in a hospital or other facility setting.

Report this code for a subsequent therapeutic aspiration in the same session, with the initial aspiration reported separately using 31645. Document the clinical reason for further airway clearance and the subsequent aspiration performed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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.

How Puerto Rico compares for 31646

Across 109 of 109 payment localities, the facility rate for 31646 runs from $120.41 in Arkansas to $172.05 in Alaska. Puerto Rico pays $129.12. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

31646 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 31646 in every payment locality

How the 31646 rate is calculated

Each of 31646’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.

Payment rules and modifiers for 31646

The CMS indicators that decide how 31646 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 31646

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

How 31646 has changed in Puerto Rico

Price 31646 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

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

Open CMS sourceHow we calculate rates