CPT code 31649: Valve removal2026 Medicare rate & RVUs in Guam
Bronchoscopic removal of bronchial valves from each lobe beyond the first is reported as an add-on to initial-lobe valve removal.
Medicare pays $72.63 for 31649 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 31649 covers
This code covers bronchoscopic removal of bronchial valves from an additional lobe after removal from the initial lobe. Interventional pulmonologists commonly perform the service in a hospital or ambulatory procedure setting for patients whose valves were placed as part of bronchoscopic lung volume reduction, often for emphysema. The work involves reaching the treated airway and removing valves in the additional lobe; the code counts lobes, not individual valves.
Report this add-on with 31648 for removal from the initial lobe, using one unit for each additional lobe treated. Documentation should identify the bronchoscopic removal, the lobes involved, and the initial-lobe removal service supporting the add-on. CMS lists this as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period.
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.
31649 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $72.63 | $61.24 |
How the 31649 rate is calculated
Each of 31649’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 · 31649
RVUs × geographic indexes × conversion factor
Work1.40
1.40 RVUs× 1.000 GPCI
Practice expense0.61
0.61 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
2.1500
Conversion factor
$33.4009
Medicare rate
$71.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31649
The CMS indicators that decide how 31649 is paid alongside other services.
CMS payment indicators · 31649
Valve removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
31649 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31648Valve removal
- 31648 covers removal from the initial lobe; 31649 is added for each additional lobe treated.
- 31647Bronchial valve placement
- 31647 is for bronchoscopic valve insertion in the initial lobe, not valve removal.
- 31651Bronchial valve
- 31651 reports valve insertion in an additional lobe; 31649 reports valve removal from an additional lobe.
31649 billing questions
When should 31649 be reported instead of 31648?
Use 31648 for removal from the initial lobe. Report 31649 for each additional lobe from which valves are removed during the service.
Is 31649 reported by valve or by lobe?
It is reported for each additional lobe, not for each individual valve removed within that lobe.
Can 31649 be billed without 31648?
No. It is an add-on code and is reported with 31648 for removal from the initial lobe.
What should the procedure note document?
Document bronchoscopic valve removal, the lobes treated, and which lobe was the initial removal service supporting 31648.
Is valve insertion coded with 31649?
No. Insertion is a different service; 31647 covers initial-lobe valve insertion and 31651 covers additional-lobe insertion.
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
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