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Billing code 31643: BronchoscopyMedicare rate & RVUs

Reports bronchoscopic placement of a catheter used to deliver a radiopharmaceutical agent, commonly for endobronchial brachytherapy in selected lung tumors.

CMS RVU26DEffective Oct 1, 2026109 payment localities44 Medicare services in 2024

Medicare pays $152.31 for 31643 nationally in a facility.

Medicare rate · 31643

Bronchoscopy

Swap in your local Medicare rate.

Work RVUs
3.4
Total RVUs
4.56
Global days
000

National rate · 2026

$152.31

Facility setting, before claim adjustments.

See every locality for 31643 → · 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 31643 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 31643 covers

A pulmonologist or interventional pulmonologist uses a rigid or flexible bronchoscope to guide a catheter through the airway for delivery of a radiopharmaceutical agent. The service is used in situations such as endobronchial brachytherapy for a lung tumor; the catheter placement is distinct from the subsequent radiation treatment. It is generally performed in a hospital or other facility equipped for therapeutic bronchoscopy and radiation procedures.

Report 31643 when the bronchoscopic catheter placement for agent delivery is performed. The procedure note should identify the catheter placement and its intended delivery purpose; a diagnostic airway inspection alone is not enough. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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% multiple-procedure reduction. Modifier 50 is inappropriate. 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.

Where 31643 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

31643 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$144.58
Alaska*Unavailable$206.80
ArizonaUnavailable$150.05
ArkansasUnavailable$143.63
AtlantaUnavailable$155.00
AustinUnavailable$153.17
BakersfieldUnavailable$153.63
Baltimore/Surr. CntysUnavailable$158.49
BeaumontUnavailable$149.00
BrazoriaUnavailable$150.89

31643 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
31643 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 31643 rate is calculated

Each of 31643’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 · 31643

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.40Practice expense 0.88Malpractice 0.28

4.5600 adjusted RVUs×$33.4009 conversion factor=$152.31

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

Payment rules and modifiers for 31643

The CMS indicators that decide how 31643 is paid alongside other services.

CMS payment indicators · 31643

Bronchoscopy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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

31643 without 51 · national facility

$152.31

Bronchoscopy

31643-51 · Second procedure: 50%

$76.16

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

31643 compared with similar codes

Compare codes

31643 vs 31622 vs 31626 vs 31627 vs 31645: national Medicare rates

Swap in your local Medicare rate.

  • 31643
    Bronchoscopy · 3.4 wRVU
    —
  • 31622
    Bronchoscopy · 2.47 wRVU
    $282.24
  • 31626
    Fiducial placement · 3.81 wRVU
    $869.43
  • 31627
    Navigational bronchoscopy · 1.95 wRVU
    $1,155.34
  • 31645
    Bronchial aspiration · 2.81 wRVU
    $308.29

How to choose

31622Bronchoscopy
Use 31622 for diagnostic bronchoscopy without catheter placement for radiopharmaceutical delivery. The catheter placement distinguishes 31643.
31626Fiducial placement
31626 covers placement of fiducial markers used for radiation targeting. 31643 is for bronchoscopic catheter placement to deliver a radiopharmaceutical agent.
31627Navigational bronchoscopy
31627 describes navigational bronchoscopy. Navigation to a lesion is different from placing a catheter for radiopharmaceutical delivery.
31645Bronchial aspiration
31645 describes therapeutic aspiration of the airway. It is not the catheter-placement service reported with 31643.

Codes related to 31643

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

Codes related to 31643
CodeHow it relatesNational office range
Used instead
31622BronchoscopyFor diagnostic airway examination without the catheter placement for agent delivery.$250.63–$370.52
31626Fiducial placementPlaces fiducial markers for radiation targeting rather than a catheter for agent delivery.$759.72–$1,198.15
Often billed with
31628Lung biopsyMay be reported in the same encounter when a separate transbronchial lung biopsy is performed.$363.40–$540.69

31643 billing questions

How is 31643 different from diagnostic bronchoscopy?

31643 requires bronchoscopic catheter placement for delivery of a radiopharmaceutical agent. A diagnostic airway examination without that placement is not 31643.

Can diagnostic bronchoscopy be reported separately for the same airway inspection?

The bronchoscopic access and inspection used to place the catheter are part of 31643. Do not separately report a diagnostic bronchoscopy code for that same work.

Is modifier 50 appropriate?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

What happens if another procedure is performed in the same session?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Medicare does not pay an assistant at surgery, and 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 31643PPRRVU2026_Oct_nonQPP.csv, line 3,650 (RVU26D)

Open CMS sourceHow we calculate rates

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