CPT code 31652: EBUS node sampling, one or two stations2026 Medicare rate & RVUs in Guam
Reports bronchoscopy with endobronchial ultrasound-guided needle sampling of one or two mediastinal or hilar lymph node stations or structures.
Medicare pays $1,513.18 for 31652 in the office in Guam (Hawaii, Guam, HI). 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.
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What 31652 covers
A pulmonologist or thoracic surgeon uses a bronchoscope with endobronchial ultrasound to locate mediastinal or hilar lymph nodes or other structures and guide needle sampling. The procedure is commonly performed in a hospital or outpatient endoscopy setting when evaluating suspected lung cancer, enlarged nodes, or other disease requiring tissue diagnosis. The ultrasound-guided sampling of one or two stations is reported with this code, whether one or multiple passes or specimens are taken from those stations.
Document the EBUS-guided targets and the number of distinct stations sampled; select the sibling code for three or more stations. The bronchoscopy and EBUS guidance for the nodal sampling are part of the service, while separately performed pathology or cytology analysis is distinct. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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.
31652 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $1,513.18 | $197.28 |
How the 31652 rate is calculated
Each of 31652’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 · 31652
RVUs × geographic indexes × conversion factor
Work4.35
4.35 RVUs× 1.000 GPCI
Practice expense35.80
35.80 RVUs× 1.000 GPCI
Malpractice0.43
0.43 RVUs× 1.000 GPCI
Adjusted RVUs
40.5800
Conversion factor
$33.4009
Medicare rate
$1,355.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31652
The CMS indicators that decide how 31652 is paid alongside other services.
CMS payment indicators · 31652
EBUS node sampling, one or two stations
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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
31652 without 51 · national office
$1,355.41
EBUS node sampling, one or two stations
31652-51 · Second procedure: 50%
$677.71
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%).
31652 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31653EBUS-guided samplingThree or more stations
- Use 31653 when EBUS-guided sampling covers three or more mediastinal or hilar stations or structures; 31652 covers one or two.
- 31629Bronchoscopic biopsyNeedle aspiration biopsy
- 31629 covers bronchoscopic transbronchial needle sampling without the EBUS-guided mediastinal or hilar nodal service. Choose based on the procedure performed and target sampled.
- 31628Lung biopsySingle lobe
- 31628 is for bronchoscopic biopsy of lung tissue. Use 31652 for EBUS-guided needle sampling of mediastinal or hilar nodes or structures.
31652 billing questions
How do I choose between 31652 and 31653?
Count the distinct mediastinal or hilar node stations or structures sampled with EBUS. Report 31652 for one or two; use 31653 for three or more.
Does each needle pass or specimen count as a separate unit?
No. The code selection is based on the number of distinct stations or structures sampled, not the number of passes or specimens.
Is EBUS guidance separately reported with 31652?
The EBUS guidance used for the nodal sampling is included in this service. Separately performed pathology or cytology analysis is a distinct service.
Can 31654 be reported in the same session?
31654 describes EBUS assessment of a peripheral lung lesion and is an add-on to a qualifying primary bronchoscopic procedure. It may be relevant when peripheral-lesion work is also performed and documented.
What does the 0-day global period mean for billing?
Same-day preoperative and postoperative care is included. CMS applies the standard multiple-procedure reduction when other procedures are performed in the same session.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. CMS does not pay an assistant at surgery for this service; co-surgeon and team-surgery billing are also 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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