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Billing code 31648: Valve removalMedicare rate & RVUs

Reports bronchoscopic removal of one or more previously placed bronchial valves from the first treated lobe, including removal performed during therapeutic airway management.

CMS RVU26DEffective Oct 1, 2026109 payment localities627 Medicare services in 2024

Medicare pays $177.02 for 31648 nationally in a facility.

Medicare rate · 31648

Valve removal

Swap in your local Medicare rate.

Work RVUs
3.85
Total RVUs
5.30
Global days
000

National rate · 2026

$177.02

Facility setting, before claim adjustments.

See every locality for 31648 → · 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 31648 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 31648 covers

An interventional pulmonologist or thoracic surgeon uses a flexible or rigid bronchoscope to remove bronchial valve(s) from the initial lobe in which valves are being removed. These valves may have been placed as part of bronchoscopic lung-volume-reduction treatment for emphysema. The service is typically performed in a facility bronchoscopy suite or operating room, with the bronchoscopist visualizing the airway and retrieving the valve device or devices from that lobe.

Report 31648 for the initial lobe; when valve removal extends to another lobe, report the additional-lobe service separately with 31649. The procedure note should identify the lobe treated and document bronchoscopic removal of the valve(s). 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. Do not use modifier 50 for bilateral reporting. Medicare does not pay an assistant at surgery for this code, 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 31648 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

31648 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$167.15
Alaska*Unavailable$238.12
ArizonaUnavailable$174.13
ArkansasUnavailable$165.94
AtlantaUnavailable$180.47
AustinUnavailable$177.97
BakersfieldUnavailable$178.10
Baltimore/Surr. CntysUnavailable$184.64
BeaumontUnavailable$172.90
BrazoriaUnavailable$175.01

31648 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
31648 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 31648 rate is calculated

Each of 31648’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 · 31648

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.85Practice expense 1.08Malpractice 0.37

5.3000 adjusted RVUs×$33.4009 conversion factor=$177.02

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

Payment rules and modifiers for 31648

The CMS indicators that decide how 31648 is paid alongside other services.

CMS payment indicators · 31648

Valve 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

31648 without 51 · national facility

$177.02

Valve removal

31648-51 · Second procedure: 50%

$88.51

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

31648 compared with similar codes

Compare codes

31648 vs 31649 vs 31647 vs 31638: national Medicare rates

Swap in your local Medicare rate.

  • 31648
    Valve removal · 3.85 wRVU
    —
  • 31649
    Valve removal · 1.4 wRVU
    $71.81
  • 31647
    Bronchial valve placement · 4.05 wRVU
    —
  • 31638
    Airway stent revision · 4.76 wRVU
    —

How to choose

31649Valve removal
31648 covers removal from the initial lobe; 31649 covers removal from each additional lobe.
31647Bronchial valve placement
31647 reports initial-lobe bronchial valve placement. Choose 31648 when the service is removal rather than placement.
31638Airway stent revision
31638 addresses revision of a bronchial stent, not removal of bronchial valves. The device and service performed determine the code.

Codes related to 31648

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

Codes related to 31648
CodeHow it relatesNational office range
Same family
31649Valve removalReports bronchial valve removal from each additional lobe.$66.67–$94.42
31647Bronchial valve placementValve-series counterpart for initial-lobe placement rather than removal.No office rate
31651Bronchial valveValve-series counterpart for placement in an additional lobe.$72.38–$102.68

31648 billing questions

When is 31648 selected instead of 31649?

Use 31648 for valve removal from the initial lobe. Use 31649 for removal from each additional lobe.

Does this code describe valve placement?

No. It describes bronchoscopic removal of previously placed bronchial valves. Code 31647 addresses initial-lobe valve placement, while 31651 addresses placement in an additional lobe.

Should modifier 50 be appended when valves are removed from both lungs?

No. The CMS bilateral adjustment does not apply to 31648, and modifier 50 is inappropriate for this service.

What documentation supports reporting 31648?

Document bronchoscopic removal of bronchial valve(s) and identify the lobe treated as the initial lobe for removal. Document additional lobes separately when reporting 31649.

How are related endoscopies handled when performed in the same session?

CMS endoscopy family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 31648. 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 31648PPRRVU2026_Oct_nonQPP.csv, line 3,654 (RVU26D)

Open CMS sourceHow we calculate rates

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