$279.78–$298.48
31645 reports the initial therapeutic aspiration in the bronchoscopy session; 31646 is for a subsequent aspiration in that same session.
On this page
CMS RVU26D · Effective 2026-10-01
31646 Bronchoscopic aspiration Medicare reimbursement rates in Missouri
Reports a subsequent therapeutic aspiration of airway secretions during the same bronchoscopy session after the initial aspiration service. Compare 31646 office and facility rates across CMS payment localities in Missouri.
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 31646 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$124.64–$127.53
3 of 3 localities have a supported rate.
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.
Where 31646 pays more and less in Missouri
Pulmonary procedures
About 31646: Subsequent therapeutic airway aspiration
Reports a subsequent therapeutic aspiration of airway secretions during the same bronchoscopy session after the initial aspiration service.
During bronchoscopy, the physician or other qualified practitioner uses suction through a flexible or rigid scope to clear additional secretions or mucus from the tracheobronchial tree. This may be needed when retained secretions or mucus plugging continue to obstruct the airways after an initial therapeutic aspiration. The service is commonly performed by a pulmonologist or thoracic surgeon in a hospital or other facility setting.
Report this code for a subsequent therapeutic aspiration in the same session, with the initial aspiration reported separately using 31645. Document the clinical reason for further airway clearance and the subsequent aspiration performed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. 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 31646
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- 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 RVU2.71 · 70%
- Practice expense (office) RVU0.88 · 23%
- Malpractice RVU0.27 · 7%
4.7K
Medicare services in 2024 · #1904 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.
31646 compared with similar codes
Office rates for Missouri, from the same CMS release.
$295.97–$314.38
Choose 31635 when the bronchoscopic service removes a foreign body. 31646 concerns subsequent therapeutic aspiration of airway secretions.
No office rate
31641 covers bronchoscopic destruction of tumor or relief of stenosis by specified methods; 31646 reports subsequent therapeutic aspiration.
Compare 31646 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$126.93
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$127.53
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$124.64
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31646 billing questions
When is 31646 reported instead of 31645?
Use 31645 for the initial therapeutic aspiration during the bronchoscopy session. Report 31646 for a subsequent therapeutic aspiration in that same session.
Does 31646 require 31645 on the claim?
Yes. The initial therapeutic aspiration is reported with 31645; 31646 describes the subsequent aspiration service.
Can routine suctioning during bronchoscopy support 31646?
Document the clinical need for further airway clearance and the subsequent therapeutic aspiration performed. Routine suctioning alone does not establish a subsequent therapeutic service.
Should modifier 50 be appended?
No. The service is not reported bilaterally, and modifier 50 is inappropriate.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's global period.
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.
3,64931641,,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
3,65531649,,Bronchial valve remov addl,A,,1.40,0.61,,0.31,,0.14,2.15,1.85,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00