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Billing code 31640: Bronchoscopic tumor removalMedicare rate & RVUs

Bronchoscopic tumor excision removes an endobronchial growth through a rigid or flexible scope when the lesion is taken out rather than simply biopsied or destroyed.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.4K Medicare services in 2024

Medicare pays $218.11 for 31640 nationally in a facility.

Medicare rate · 31640

Bronchoscopic tumor removal

Swap in your local Medicare rate.

Work RVUs
4.81
Total RVUs
6.53
Global days
000

National rate · 2026

$218.11

Facility setting, before claim adjustments.

See every locality for 31640 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 31640 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 31640 covers

This service removes a tumor growing within an airway through a rigid or flexible bronchoscope. Pulmonologists and thoracic surgeons commonly perform it in a hospital procedure suite or operating room, for example to remove an endobronchial growth that narrows or obstructs a bronchus. The procedure may yield tissue for pathologic examination, but the defining service is excision of the tumor, not sampling alone.

Report the code when the operative note supports bronchoscopic removal of tumor tissue. Document the airway site, the lesion treated, and the excision performed; distinguish removal from destruction or treatment of stenosis by another method. Medicare 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. 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.

Where 31640 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

31640 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$206.39
Alaska*Unavailable$294.62
ArizonaUnavailable$214.67
ArkansasUnavailable$204.95
AtlantaUnavailable$222.23
AustinUnavailable$219.23
BakersfieldUnavailable$219.52
Baltimore/Surr. CntysUnavailable$227.28
BeaumontUnavailable$213.22
BrazoriaUnavailable$215.78

31640 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
31640 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 31640 rate is calculated

Each of 31640’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 · 31640

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.81Practice expense 1.28Malpractice 0.44

6.5300 adjusted RVUs×$33.4009 conversion factor=$218.11

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 31640

The CMS indicators that decide how 31640 is paid alongside other services.

CMS payment indicators · 31640

Bronchoscopic tumor removal

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

31640 without 51 · national facility

$218.11

Bronchoscopic tumor removal

31640-51 · Second procedure: 50%

$109.06

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%).

When to use modifier 51

31640 compared with similar codes

Compare codes

31640 vs 31641 vs 31635 vs 31630: national Medicare rates

Swap in your local Medicare rate.

  • 31640
    Bronchoscopic tumor removal · 4.81 wRVU
    —
  • 31641
    Therapeutic bronchoscopy · 4.89 wRVU
    —
  • 31635
    Bronchoscopy · 3.33 wRVU
    $323.99
  • 31630
    Bronchoscopy · 3.71 wRVU
    —

How to choose

31641Therapeutic bronchoscopy
Choose 31640 for excision of tumor tissue. Choose 31641 when the bronchoscopic treatment destroys tumor or relieves stenosis without excising the tumor.
31635Bronchoscopy
31635 applies to bronchoscopic removal of a foreign body. It does not describe removal of an endobronchial tumor.
31630Bronchoscopy
31630 is for bronchoscopic airway dilation. Use 31640 when the service is excision of a tumor, rather than dilation of a narrowed airway.

Codes related to 31640

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

Codes related to 31640
CodeHow it relatesNational office range
Used instead
31641Therapeutic bronchoscopyUsed when bronchoscopic treatment destroys a tumor or relieves stenosis rather than excising the tumor.No office rate
31635BronchoscopyReports bronchoscopic removal of a foreign body, not excision of an airway tumor.$289.85–$419.37
31630BronchoscopyReports bronchoscopic airway dilation when dilation, rather than tumor excision, is the service performed.No office rate

31640 billing questions

How is tumor excision different from tumor destruction?

Use 31640 when the bronchoscopic service removes tumor tissue. Code 31641 is the relevant comparison when the tumor is destroyed, or stenosis is treated, rather than excised.

Does a tumor biopsy alone support 31640?

No. The documentation should show that the tumor was excised, not merely sampled; a biopsy-only service is not tumor excision.

What should the procedure note document?

Identify the airway site and tumor, and describe the bronchoscopic excision performed. The note should make clear that tissue was removed rather than only biopsied or destroyed.

How does Medicare price related endoscopies performed together?

Endoscopy family pricing applies when related endoscopies are performed in the same session. The applicable payment reflects that family-pricing rule.

Can modifier 50 or an assistant-at-surgery claim be reported?

Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for it; 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

Show the CMS file lines behind this rate
RVUs for 31640PPRRVU2026_Oct_nonQPP.csv, line 3,648 (RVU26D)

Open CMS sourceHow we calculate rates

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