No office rate
Choose 31640 for excision of tumor tissue. Choose 31641 when the bronchoscopic treatment destroys tumor or relieves stenosis without excising the tumor.
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CMS RVU26D · Effective 2026-10-01
31640 Bronchoscopic tumor removal Medicare reimbursement rates in Iowa
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. Compare 31640 office and facility rates across CMS payment localities in Iowa.
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.
What does Medicare pay for 31640 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$205.61
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Pulmonary endoscopy
About 31640: Bronchoscopic airway tumor excision
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.
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.
CMS billing rules for 31640
- 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 RVU4.81 · 74%
- Practice expense (office) RVU1.28 · 20%
- Malpractice RVU0.44 · 7%
1.4K
Medicare services in 2024 · #2710 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.
31640 compared with similar codes
Office rates for Iowa, from the same CMS release.
$299.68
31635 applies to bronchoscopic removal of a foreign body. It does not describe removal of an endobronchial tumor.
No office rate
31630 is for bronchoscopic airway dilation. Use 31640 when the service is excision of a tumor, rather than dilation of a narrowed airway.
Compare 31640 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$205.61
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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 31640 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,648
- Code
- 31640
- Physician work
- 4.81
- Practice expense
- 1.28
- Malpractice
- 0.44
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.81 | × 1.000 | 4.8100 |
| Practice expense | 1.28 | × 0.915 | 1.1712 |
| Malpractice | 0.44 | × 0.397 | 0.1747 |
| Total RVUs | 6.1559 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$205.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.81 | 1 |
| Practice expense | 1.28 | 0.915 |
| Malpractice | 0.44 | 0.397 |
(4.81 × 1 + 1.28 × 0.915 + 0.44 × 0.397) × $33.4009 = $205.61
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.
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 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.
3,64531636,,Bronchoscopy bronch stents,A,,4.19,1.22,NA,1.22,,0.44,5.85,5.85,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,64631637,,Bronchoscopy stent add-on,A,,1.54,0.32,NA,0.32,,0.15,2.01,2.01,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,64731638,,Bronchoscopy revise stent,A,,4.76,1.32,NA,1.32,,0.48,6.56,6.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,64831640,,Bronchoscopy w/tumor excise,A,,4.81,1.28,NA,1.28,,0.44,6.53,6.53,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,64931641,,Bronchoscopy treat blockage,A,,4.89,1.34,NA,1.34,,0.49,6.72,6.72,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,65031643,,Diag bronchoscope/catheter,A,,3.40,0.88,NA,0.88,,0.28,4.56,4.56,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,65131645,,Brnchsc w/ther aspir 1st,A,,2.81,6.13,,0.89,,0.29,9.23,3.99,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136