No office rate
31645 is for the initial therapeutic aspiration; 31646 is the add-on for subsequent therapeutic aspiration.
On this page
CMS RVU26D · Effective 2026-10-01
31645 Bronchial aspiration Medicare reimbursement rates in Iowa
Reports initial bronchoscopic therapeutic aspiration to clear airway secretions, mucus plugs, or other material obstructing the tracheobronchial tree. Compare 31645 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 31645 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
$285.05
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$124.90
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.
Pulmonology procedure
About 31645: Initial therapeutic bronchoscopy with airway aspiration
Reports initial bronchoscopic therapeutic aspiration to clear airway secretions, mucus plugs, or other material obstructing the tracheobronchial tree.
A pulmonologist, interventional pulmonologist, or other qualified physician uses a bronchoscope to aspirate material from the trachea or bronchi. Typical situations include clearing tenacious secretions or mucus plugging associated with atelectasis, impaired airway clearance, or respiratory distress, including in hospitalized or intensive care patients. This is therapeutic airway clearance, not aspiration performed solely to collect a diagnostic specimen.
Report 31645 for the initial therapeutic aspiration; report 31646 for subsequent therapeutic aspiration when appropriate. Document the clinical reason for airway clearance and the material and airway sites treated. The code has 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 31645
- 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 RVU2.81 · 30%
- Practice expense (office) RVU6.13 · 66%
- Malpractice RVU0.29 · 3%
42.4K
Medicare services in 2024 · #846 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.
31645 compared with similar codes
Office rates for Iowa, from the same CMS release.
$265.03
Choose 31624 when bronchoalveolar lavage is performed for lavage or sampling. Choose 31645 when the purpose is therapeutic removal of airway material.
$299.68
31635 is for bronchoscopic removal of a foreign body. 31645 is for therapeutic aspiration, such as clearing secretions or mucus plugs.
No office rate
31641 describes bronchoscopic treatment of an airway blockage; 31645 describes clearing material by therapeutic aspiration.
Compare 31645 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
$285.05
Facility
$124.90
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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 31645 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,651
- Code
- 31645
- Physician work
- 2.81
- Practice expense
- 6.13
- Malpractice
- 0.29
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.81 | × 1.000 | 2.8100 |
| Practice expense | 6.13 | × 0.915 | 5.6090 |
| Malpractice | 0.29 | × 0.397 | 0.1151 |
| Total RVUs | 8.5341 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$285.05
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.81 | 1 |
| Practice expense | 6.13 | 0.915 |
| Malpractice | 0.29 | 0.397 |
(2.81 × 1 + 6.13 × 0.915 + 0.29 × 0.397) × $33.4009 = $285.05
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.81 | 1 |
| Practice expense | 0.89 | 0.915 |
| Malpractice | 0.29 | 0.397 |
(2.81 × 1 + 0.89 × 0.915 + 0.29 × 0.397) × $33.4009 = $124.90
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.
31645 billing questions
When is 31646 used instead of 31645?
31645 identifies the initial therapeutic aspiration. 31646 is the companion code for subsequent therapeutic aspiration when performed.
Is airway aspiration the same as bronchoalveolar lavage?
No. Report 31645 for therapeutic removal of obstructing material; 31624 describes bronchoscopy with bronchoalveolar lavage, commonly performed to obtain a lower-airway sample.
Does removing a foreign body belong under 31645?
When the procedure removes a foreign body, compare 31635. 31645 describes therapeutic aspiration, such as clearing secretions or mucus plugs.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
How does Medicare handle related endoscopies performed together?
Endoscopy family pricing applies when related endoscopies are performed together. The code also has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant, co-surgeon, or surgical team be paid?
Medicare does not pay an assistant at surgery for 31645. 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.
3,64831640,,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
3,65231646,,Brnchsc w/ther aspir sbsq,A,,2.71,0.88,NA,0.88,,0.27,3.86,3.86,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,65331647,,Bronchial valve init insert,A,,4.05,1.11,NA,1.11,,0.38,5.54,5.54,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,65431648,,Bronchial valve remov init,A,,3.85,1.08,NA,1.08,,0.37,5.30,5.30,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
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