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CMS RVU26D · Effective 2026-10-01

31628 in Redding

Office / nonfacility

$432.41

Base rate per service

Facility setting

$158.58

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Pulmonary endoscopy

About 31628: Transbronchial lung biopsy, one lobe

Report this bronchoscopy when transbronchial lung tissue is sampled from one lobe; use the companion add-on code for each additional lobe.

A pulmonologist or interventional pulmonologist passes a bronchoscope into the airways and obtains lung tissue through the bronchial wall, typically with biopsy forceps. The code represents sampling from one lobe during a diagnostic evaluation, such as investigating diffuse lung disease, infection, or a suspected pulmonary lesion. The procedure is commonly performed in a hospital or ambulatory surgery setting; imaging guidance may be used.

Choose this code based on the transbronchial biopsy method and one lobe sampled, not the number of tissue fragments. Record the biopsy technique, sampled lobe, and findings; report 31632 for each additional lobe sampled in the same session. When related endoscopies are performed together, CMS applies endoscopy family pricing. The 0-day global period includes same-day preoperative and postoperative care. Bilateral adjustment is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

CMS billing rules for 31628

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Endoscopy family pricing applies when related endoscopies are performed together.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.46 · 28%
  • Practice expense (office) RVU8.44 · 69%
  • Malpractice RVU0.33 · 3%

43.3K

Medicare services in 2024 · #835 by national volume

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.

31628 compared with similar codes

Office rates for Redding, from the same CMS release.

31625

Bronchoscopy biopsy

Airway tissue sampling

$407.38

Use 31628 for transbronchial sampling of lung tissue. Use 31625 when the biopsy target is an endobronchial site.

31629

Bronchoscopic biopsy

Needle aspiration biopsy

$528.33

31629 is for transbronchial needle biopsy or aspiration. This code is for transbronchial lung tissue biopsy using a different sampling method.

31632

Lung biopsy

Each additional lobe

$71.28

31628 covers the first lobe sampled; 31632 reports each additional lobe sampled during the session.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 31628 is $433.44—$1.03 higher than the $432.41 rate in Redding. Both use the same code, release and participation basis.

31628 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $432.41

  2. Bakersfield

    $433.44

    $1.03 higher than Redding

  3. Chico

    $432.41

    The same base rate than Redding

  4. El Centro

    $432.46

    $0.05 higher than Redding

  5. Fresno

    $432.41

    The same base rate than Redding

  6. Hanford-Corcoran

    $432.41

    The same base rate than Redding

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $461.12

    $28.71 higher than Redding

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 31628 ranges from $363.40 in Arkansas to $540.69 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 31628

    Office

    $432.41

    Facility

    $158.58

    The same base rate than Redding for the office setting.

  • Merced

    California · 31628

    Office

    $432.41

    Facility

    $158.58

    The same base rate than Redding for the office setting.

  • Modesto

    California · 31628

    Office

    $432.41

    Facility

    $158.58

    The same base rate than Redding for the office setting.

  • Napa

    California · 31628

    Office

    $500.00

    Facility

    $170.71

    $67.59 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 31628

    Office

    $458.88

    Facility

    $163.57

    $26.47 higher than Redding for the office setting.

  • Rest Of California

    California · 31628

    Office

    $432.41

    Facility

    $158.58

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 31628

    Office

    $436.02

    Facility

    $162.19

    $3.61 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 31628

    Office

    $453.49

    Facility

    $162.93

    $21.08 higher than Redding for the office setting.

  • Salinas

    California · 31628

    Office

    $451.78

    Facility

    $162.22

    $19.37 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 31628

    Office

    $462.16

    Facility

    $163.36

    $29.75 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 31628

    Office

    $529.09

    Facility

    $176.82

    $96.68 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 31628

    Office

    $528.71

    Facility

    $176.44

    $96.30 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 31628

    Office

    $540.69

    Facility

    $180.42

    $108.28 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 31628

    Office

    $539.16

    Facility

    $178.89

    $106.75 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 31628

    Office

    $444.53

    Facility

    $159.96

    $12.12 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 31628

    Office

    $466.41

    Facility

    $162.86

    $34.00 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 31628

    Office

    $453.41

    Facility

    $162.10

    $21.00 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 31628

    Office

    $471.12

    Facility

    $164.32

    $38.71 higher than Redding for the office setting.

  • Stockton

    California · 31628

    Office

    $432.41

    Facility

    $158.58

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 31628

    Office

    $499.46

    Facility

    $170.17

    $67.05 higher than Redding for the office setting.

  • Visalia

    California · 31628

    Office

    $432.41

    Facility

    $158.58

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 31628

    Office

    $432.41

    Facility

    $158.58

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 31628

    Office

    $466.16

    Facility

    $171.85

    $33.75 higher than Redding for the office setting.

  • Miami

    Florida · 31628

    Office

    $436.90

    Facility

    $176.82

    $4.49 higher than Redding for the office setting.

  • Chicago

    Illinois · 31628

    Office

    $424.99

    Facility

    $173.90

    $7.42 lower than Redding for the office setting.

  • Manhattan

    New York · 31628

    Office

    $468.02

    Facility

    $177.70

    $35.61 higher than Redding for the office setting.

  • Alaska*

    Alaska · 31628

    Office

    $479.65

    Facility

    $213.57

    $47.24 higher than Redding for the office setting.

  • Alabama

    Alabama · 31628

    Office

    $368.47

    Facility

    $149.86

    $63.94 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 31628

    Office

    $363.40

    Facility

    $148.79

    $69.01 lower than Redding for the office setting.

  • Arizona

    Arizona · 31628

    Office

    $398.17

    Facility

    $156.07

    $34.24 lower than Redding for the office setting.

  • Colorado

    Colorado · 31628

    Office

    $425.51

    Facility

    $159.68

    $6.90 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 31628

    Office

    $434.83

    Facility

    $165.75

    $2.42 higher than Redding for the office setting.

  • Delaware

    Delaware · 31628

    Office

    $404.57

    Facility

    $157.73

    $27.84 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 31628

    Office

    $421.06

    Facility

    $167.98

    $11.35 lower than Redding for the office setting.

  • Rest Of Florida

    Florida · 31628

    Office

    $401.63

    Facility

    $162.79

    $30.78 lower than Redding for the office setting.

  • Atlanta

    Georgia · 31628

    Office

    $415.57

    Facility

    $161.73

    $16.84 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 31628

    Office

    $380.16

    Facility

    $157.31

    $52.25 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 31628

    Office

    $442.47

    Facility

    $158.41

    $10.06 higher than Redding for the office setting.

  • Iowa

    Iowa · 31628

    Office

    $377.88

    Facility

    $149.28

    $54.53 lower than Redding for the office setting.

  • Idaho

    Idaho · 31628

    Office

    $380.13

    Facility

    $150.28

    $52.28 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 31628

    Office

    $397.12

    Facility

    $167.27

    $35.29 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 31628

    Office

    $390.17

    Facility

    $162.07

    $42.24 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 31628

    Office

    $425.42

    Facility

    $168.84

    $6.99 lower than Redding for the office setting.

  • Indiana

    Indiana · 31628

    Office

    $382.25

    Facility

    $150.65

    $50.16 lower than Redding for the office setting.

  • Kansas

    Kansas · 31628

    Office

    $375.96

    Facility

    $150.11

    $56.45 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 31628

    Office

    $376.26

    Facility

    $154.16

    $56.15 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 31628

    Office

    $393.36

    Facility

    $158.26

    $39.05 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 31628

    Office

    $375.61

    Facility

    $154.50

    $56.80 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 31628

    Office

    $466.71

    Facility

    $168.40

    $34.30 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 31628

    Office

    $423.05

    Facility

    $159.97

    $9.36 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 31628

    Office

    $433.53

    Facility

    $165.46

    $1.12 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 31628

    Office

    $412.13

    Facility

    $159.29

    $20.28 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 31628

    Office

    $381.77

    Facility

    $151.92

    $50.64 lower than Redding for the office setting.

  • Southern Maine

    Maine · 31628

    Office

    $401.89

    Facility

    $154.30

    $30.52 lower than Redding for the office setting.

  • Detroit

    Michigan · 31628

    Office

    $406.19

    Facility

    $165.09

    $26.22 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 31628

    Office

    $385.39

    Facility

    $157.29

    $47.02 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 31628

    Office

    $408.91

    Facility

    $151.82

    $23.50 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 31628

    Office

    $391.04

    Facility

    $156.44

    $41.37 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 31628

    Office

    $394.98

    Facility

    $157.14

    $37.43 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 31628

    Office

    $369.30

    Facility

    $153.94

    $63.11 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 31628

    Office

    $366.43

    Facility

    $151.32

    $65.98 lower than Redding for the office setting.

  • Montana**

    Montana · 31628

    Office

    $408.47

    Facility

    $158.63

    $23.94 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 31628

    Office

    $385.63

    Facility

    $152.53

    $46.78 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 31628

    Office

    $401.95

    Facility

    $152.11

    $30.46 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 31628

    Office

    $379.93

    Facility

    $149.33

    $52.48 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 31628

    Office

    $418.67

    Facility

    $158.59

    $13.74 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 31628

    Office

    $461.63

    Facility

    $171.81

    $29.22 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 31628

    Office

    $440.12

    Facility

    $167.30

    $7.71 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 31628

    Office

    $387.31

    Facility

    $158.21

    $45.10 lower than Redding for the office setting.

  • Nevada**

    Nevada · 31628

    Office

    $406.93

    Facility

    $156.85

    $25.48 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 31628

    Office

    $478.62

    Facility

    $181.56

    $46.21 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 31628

    Office

    $442.79

    Facility

    $169.22

    $10.38 higher than Redding for the office setting.

  • Queens

    New York · 31628

    Office

    $472.07

    Facility

    $176.76

    $39.66 higher than Redding for the office setting.

  • Rest Of New York

    New York · 31628

    Office

    $391.12

    Facility

    $153.78

    $41.29 lower than Redding for the office setting.

  • Ohio

    Ohio · 31628

    Office

    $384.06

    Facility

    $155.95

    $48.35 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 31628

    Office

    $375.87

    Facility

    $152.77

    $56.54 lower than Redding for the office setting.

  • Portland

    Oregon · 31628

    Office

    $438.81

    Facility

    $161.24

    $6.40 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 31628

    Office

    $404.09

    Facility

    $155.25

    $28.32 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 31628

    Office

    $424.26

    Facility

    $164.18

    $8.15 lower than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 31628

    Office

    $384.77

    Facility

    $155.42

    $47.64 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 31628

    Office

    $411.43

    Facility

    $158.84

    $20.98 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 31628

    Office

    $418.80

    Facility

    $160.72

    $13.61 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 31628

    Office

    $385.41

    Facility

    $154.56

    $47.00 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 31628

    Office

    $401.17

    Facility

    $151.34

    $31.24 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 31628

    Office

    $377.74

    Facility

    $150.63

    $54.67 lower than Redding for the office setting.

  • Austin

    Texas · 31628

    Office

    $423.82

    Facility

    $159.49

    $8.59 lower than Redding for the office setting.

  • Beaumont

    Texas · 31628

    Office

    $382.34

    Facility

    $154.99

    $50.07 lower than Redding for the office setting.

  • Brazoria

    Texas · 31628

    Office

    $404.46

    Facility

    $156.87

    $27.95 lower than Redding for the office setting.

  • Dallas

    Texas · 31628

    Office

    $406.84

    Facility

    $158.00

    $25.57 lower than Redding for the office setting.

  • Fort Worth

    Texas · 31628

    Office

    $404.16

    Facility

    $157.82

    $28.25 lower than Redding for the office setting.

  • Galveston

    Texas · 31628

    Office

    $405.55

    Facility

    $157.46

    $26.86 lower than Redding for the office setting.

  • Houston

    Texas · 31628

    Office

    $411.59

    Facility

    $163.50

    $20.82 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 31628

    Office

    $393.05

    Facility

    $155.95

    $39.36 lower than Redding for the office setting.

  • Utah

    Utah · 31628

    Office

    $390.45

    Facility

    $155.61

    $41.96 lower than Redding for the office setting.

  • Virginia

    Virginia · 31628

    Office

    $400.46

    Facility

    $154.87

    $31.95 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 31628

    Office

    $411.43

    Facility

    $158.84

    $20.98 lower than Redding for the office setting.

  • Vermont

    Vermont · 31628

    Office

    $400.23

    Facility

    $152.89

    $32.18 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 31628

    Office

    $422.30

    Facility

    $159.22

    $10.11 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 31628

    Office

    $476.25

    Facility

    $169.69

    $43.84 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 31628

    Office

    $389.03

    Facility

    $149.68

    $43.38 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 31628

    Office

    $376.31

    Facility

    $159.20

    $56.10 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 31628

    Office

    $405.63

    Facility

    $155.79

    $26.78 lower than Redding for the office setting.

See how rates vary across the country

31628 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$363.40

$486.55

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$479.651
AL$368.471
AR$363.401
AZ$398.171
CA$432.41–$540.6929
CO$425.511
CT$434.831
DC$466.161
DE$404.571
FL$401.63–$436.903
GA$380.16–$415.572
GU$442.471
HI$442.471
IA$377.881
ID$380.131
IL$390.17–$425.424
IN$382.251
KS$375.961
KY$376.261
LA$375.61–$393.362
MA$423.05–$466.712
MD$412.13–$466.163
ME$381.77–$401.892
MI$385.39–$406.192
MN$408.911
MO$369.30–$394.983
MS$366.431
MT$408.471
NC$385.631
ND$401.951
NE$379.931
NH$418.671
NJ$440.12–$461.632
NM$387.311
NV$406.931
NY$391.12–$478.625
OH$384.061
OK$375.871
OR$404.09–$438.812
PA$384.77–$424.262
PR$411.431
RI$418.801
SC$385.411
SD$401.171
TN$377.741
TX$382.34–$423.828
UT$390.451
VA$400.46–$466.162
VI$411.431
VT$400.231
WA$422.30–$476.252
WI$389.031
WV$376.311
WY$405.631

Explore 31628 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 31628 in Redding, the physician’s office rate is $432.41 and the facility-setting rate is $158.58: a difference of $273.83.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 31628 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$475.65

$432.41 × 110% = $475.65

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 31628 in Redding.

PPRRVU2026_Oct_nonQPP.csv

3,637

Code
31628
Physician work
3.46
Practice expense
8.44
Malpractice
0.33

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 31628 in Redding
ComponentRVULocality factorAdjusted
Physician work3.46× 1.0173.5188
Practice expense8.44× 1.0969.2502
Malpractice0.33× 0.5360.1769
Total RVUs12.9459
Conversion factor× 33.4009

Office / nonfacility rate, Redding$432.41

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 31628 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.461.017
Practice expense8.441.096
Malpractice0.330.536

(3.46 × 1.017 + 8.44 × 1.096 + 0.33 × 0.536) × $33.4009 = $432.41

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.461.017
Practice expense0.961.096
Malpractice0.330.536

(3.46 × 1.017 + 0.96 × 1.096 + 0.33 × 0.536) × $33.4009 = $158.58

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

31628 · Office / nonfacility

$432.41

Effective 2026-10-01

The base rate is $58.29 higher than on 2025-10-01, moving from $374.12 to $432.41 (15.6%).

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

    $374.12changed to$432.41

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.55 changed to 3.46
    • Practice expense RVU 7.14 changed to 8.44
    • Malpractice RVU 0.29 changed to 0.33
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $374.12

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$432.41$158.58RVU26D
2026-07-01$432.41$158.58RVU26C
2026-04-01$432.41$158.58RVU26B
2026-01-01$432.41$158.58RVU26A
2025-10-01$374.12$168.01RVU25D
2025-07-01$374.12$168.01RVU25C
2025-04-01$374.12$168.01RVU25B
2025-01-01$374.12$168.01RVU25A

31628 billing questions

How is this different from 31625?

31628 is for tissue sampled from lung parenchyma through the bronchial wall. Code 31625 describes biopsy of an endobronchial site, such as visible airway mucosa or a lesion within the bronchus.

Does the number of biopsy fragments change the code?

No. This code covers transbronchial lung biopsy in one lobe, regardless of the number of tissue fragments obtained. Use 31632 for each additional lobe sampled.

Can diagnostic bronchoscopy be reported separately?

The inspection needed to perform the biopsy is part of the bronchoscopy service. Do not separately report a diagnostic bronchoscopy for that same inspection during the biopsy session.

Should modifier 50 be used for biopsies in both lungs?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the lobes sampled, including the additional-lobe add-on when applicable.

What documentation supports reporting 31628 with 31632?

Document the transbronchial biopsy method and identify each lobe sampled. The record should support one lobe for 31628 and each additional lobe reported with 31632.

How does Medicare price this with another related endoscopy?

CMS applies endoscopy family pricing when related endoscopies are performed together. The 0-day global period includes same-day preoperative and postoperative care.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 31628PPRRVU2026_Oct_nonQPP.csv, line 3,637 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet