CPT code 31654: Bronchoscopy guidance, peripheral lesion localization2026 Medicare rate & RVUs in New Mexico

Add-on bronchoscopy guidance using endobronchial ultrasound to localize peripheral pulmonary lesions during a separately reported bronchoscopic procedure, commonly for tissue sampling.

CMS RVU26DEffective Oct 1, 2026One payment locality27.3K Medicare services in 2024

In New Mexico, Medicare pays $125.40 for 31654 in the office and $59.86 when it’s performed in a hospital or facility.

$125.40Office (non-facility)
$59.86Hospital or facility
−4.5%vs the national office rate ($131.27)

Check a contract rate as a % of Medicare · 31654 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 31654 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 31654 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 31654 covers

During bronchoscopy, the physician advances an endobronchial ultrasound probe to locate a peripheral lung lesion and guide the bronchoscopic procedure toward it. This is commonly used by pulmonologists and interventional pulmonologists when a lung nodule or other peripheral abnormality is difficult to target by direct airway visualization. The code represents EBUS guidance for peripheral lesions, not EBUS-guided sampling of mediastinal or hilar lymph nodes.

Report 31654 only with a primary bronchoscopy procedure; examples of tissue-acquisition procedures that may be paired include transbronchial lung biopsy (31628) and transbronchial needle aspiration (31629), when performed. Documentation should identify the peripheral target and describe use of EBUS to localize or guide work on that lesion. CMS treats this as an add-on code, paid within the primary procedure's global period; it is not reported as a standalone service.

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 New Mexico compares for 31654

Across 109 of 109 payment localities, the office rate for 31654 runs from $117.72 in Arkansas to $170.16 in San Benito County, CA. New Mexico pays $125.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

31654 in New Mexico vs other payment areas
  1. New Mexico · this page$125.40
  2. Los Angeles, CA · California$146.54+$21.14
  3. Washington, DC area · District of Columbia$148.67+$23.27
  4. Miami, FL · Florida$141.23+$15.83
  5. Chicago, IL · Illinois$137.61+$12.21
  6. Manhattan, NY · New York$149.89+$24.49
  7. Alaska · Alaska$157.47+$32.07

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

31654 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$119.24$56.69
ArkansasArkansas$117.72$56.32
ArizonaArizona$128.12$58.86
Bakersfield, CACalifornia$138.23$59.89
Chico, CACalifornia$137.82$59.48
El Centro, CACalifornia$137.84$59.50
Fresno, CACalifornia$137.82$59.48
Hanford, CACalifornia$137.82$59.48

31654 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.

$117.72

$157.47

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
31654 office rate range by state
State / territoryOffice rate rangeLocalities
AK$157.471
AL$119.241
AR$117.721
AZ$128.121
CA$137.82–$170.1629
CO$136.061
CT$139.341
DC$148.671
DE$130.081
FL$129.88–$141.233
GA$123.33–$133.572
GU$140.561
HI$140.561
IA$121.751
ID$122.481
IL$126.65–$137.614
IN$123.111
KS$121.321
KY$121.891
LA$121.75–$127.072
MA$135.42–$148.412
MD$132.34–$148.673
ME$123.13–$128.932
MI$124.76–$131.402
MN$130.561
MO$119.95–$127.383
MS$118.851
MT$131.261
NC$124.261
ND$128.691
NE$122.321
NH$134.051
NJ$140.98–$147.432
NM$125.401
NV$130.621
NY$125.92–$153.265
OH$124.241
OK$121.611
OR$129.65–$139.902
PA$124.37–$136.252
PR$132.091
RI$134.341
SC$124.451
SD$128.381
TN$121.871
TX$123.65–$135.578
UT$125.951
VA$128.61–$148.672
VI$132.091
VT$128.311
WA$135.12–$151.182
WI$124.851
WV$122.501
WY$130.141

See 31654 in every payment locality

How the 31654 rate is calculated

Each of 31654’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 · 31654

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.37

1.37 RVUs× 1.000 GPCI

Practice expense2.43

2.43 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

3.9300

Conversion factor

$33.4009

Medicare rate

$131.27

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,659

Code
31654
Physician work
1.37
Practice expense
2.43
Malpractice
0.13

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 31654 in New Mexico
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0001.3700
Practice expense2.43× 0.9172.2283
Malpractice0.13× 1.2010.1561
Total RVUs3.7544
Conversion factor× 33.4009

Office rate, New Mexico$125.40

Office: (1.37 × 1 + 2.43 × 0.917 + 0.13 × 1.201) × $33.4009 = $125.40

Facility: (1.37 × 1 + 0.29 × 0.917 + 0.13 × 1.201) × $33.4009 = $59.86

Open 31654 in the RVU calculator

Payment rules and modifiers for 31654

The CMS indicators that decide how 31654 is paid alongside other services.

CMS payment indicators · 31654

Bronchoscopy guidance, peripheral lesion localization

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 31654 has changed in New Mexico

31654 · Office / nonfacility

$125.40

Effective 2026-10-01

The base rate is $15.27 higher than on 2025-10-01, moving from $110.13 to $125.40 (13.9%).

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

    $110.13changed to$125.40

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.40 changed to 1.37
    • Practice expense RVU 2.04 changed to 2.43
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $114.24changed to$110.13

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.07 changed to 2.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $112.38changed to$114.24

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $115.16changed to$112.38

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.06 changed to 2.07
    • Malpractice RVU 0.12 changed to 0.13
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $118.62changed to$115.16

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.12 changed to 2.06
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $119.61changed to$118.62

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $119.87changed to$119.61

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.97 changed to 2.12
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $122.56changed to$119.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.01 changed to 1.97
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $124.09changed to$122.56

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.06 changed to 2.01

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $123.88changed to$124.09

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $140.09changed to$123.88

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.57 changed to 2.06
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$140.09

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$125.40$59.86RVU26D
2026-07-01$125.40$59.86RVU26C
2026-04-01$125.40$59.86RVU26B
2026-01-01$125.40$59.86RVU26A
2025-10-01$110.13$62.84RVU25D
2025-07-01$110.13$62.84RVU25C
2025-04-01$110.13$62.84RVU25B
2025-01-01$110.13$62.84RVU25A
2024-10-01$114.24$64.67RVU24D
2024-07-01$114.24$64.67RVU24C
2024-04-01$114.24$64.67RVU24B
2024-03-09$114.24$64.67RVU24AR
2024-01-01$112.38$63.62RVU24A
2023-10-01$115.16$65.03RVU23D
2023-07-01$115.16$65.03RVU23C
2023-04-01$115.16$65.03RVU23B
2023-01-01$115.16$65.03RVU23A
2022-10-01$118.62$66.53RVU22D
2022-07-01$118.62$66.53RVU22C
2022-04-01$118.62$66.53RVU22B
2022-01-01$118.62$66.53RVU22A
2021-10-01$119.61$67.08RVU21D
2021-07-01$119.61$67.08RVU21C
2021-04-01$119.61$67.08RVU21B
2021-01-01$119.61$67.08RVU21A
2020-10-01$119.87$69.41RVU20D
2020-07-01$119.87$69.41RVU20C
2020-04-01$119.87$69.41RVU20B
2020-01-01$119.87$69.41RVU20A
2019-10-01$122.56$69.79RVU19D
2019-07-01$122.56$69.79RVU19C
2019-04-01$122.56$69.79RVU19B
2019-01-01$122.56$69.79RVU19A
2018-10-01$124.09$70.04RVU18D
2018-07-01$124.09$70.04RVU18C
2018-04-01$124.09$70.04RVU18B
2018-01-01$124.09$70.04RVU18AR1
2017-10-01$123.88$70.06RVU17D
2017-07-01$123.88$70.06RVU17C
2017-04-01$123.88$70.06RVU17B
2017-01-01$123.88$70.06RVU17A
2016-10-01$140.09$69.35RVU16D
2016-07-01$140.09$69.35RVU16C
2016-04-01$140.09$69.35RVU16B
2016-01-01$140.09$69.35RVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 31654 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

31654 billing questions

When is 31654 appropriate instead of 31652 or 31653?

Use 31654 for EBUS guidance of a peripheral pulmonary lesion. Codes 31652 and 31653 describe EBUS-guided sampling of mediastinal or hilar lymph nodes.

Can 31654 be reported by itself?

No. It is an add-on code and must be reported with a primary bronchoscopy procedure, such as an appropriate biopsy or aspiration service.

Can 31654 be paired with 31628 or 31629?

It may be paired with 31628 for transbronchial lung biopsy or 31629 for transbronchial needle aspiration when that procedure is performed on the peripheral lesion.

What documentation supports reporting 31654?

Document the peripheral pulmonary target and the use of endobronchial ultrasound to locate or guide the bronchoscopic work on that lesion.

Is 31654 reported once for each lesion?

The code covers EBUS guidance for peripheral lesion(s). Do not assume a separate unit for each lesion from the code description alone.

How does the add-on status affect payment?

CMS pays 31654 within the global period of the primary procedure, and it cannot be billed as a standalone 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
RVUs for 31654PPRRVU2026_Oct_nonQPP.csv, line 3,659 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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