$379.93
31628 reports transbronchial lung biopsy; 31654 reports the additional EBUS guidance used to localize a peripheral lesion when that guidance is performed.
On this page
CMS RVU26D · Effective 2026-10-01
31654 Bronchoscopy guidance Medicare reimbursement rates in Nebraska
Add-on bronchoscopy guidance using endobronchial ultrasound to localize peripheral pulmonary lesions during a separately reported bronchoscopic procedure, commonly for tissue sampling. Compare 31654 office and facility rates across CMS payment localities in Nebraska.
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 31654 in Nebraska?
Nebraska 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
$122.32
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$56.34
1 of 1 localities have a supported rate.
Payment area: Nebraska
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
About 31654: Peripheral lesion EBUS guidance
Add-on bronchoscopy guidance using endobronchial ultrasound to localize peripheral pulmonary lesions during a separately reported bronchoscopic procedure, commonly for tissue sampling.
During bronchoscopy, the physician advances an endobronchial ultrasound probe to locate a peripheral lung lesion and guide the bronchoscopic procedure toward it. This is commonly used by pulmonologists and interventional pulmonologists when a lung nodule or other peripheral abnormality is difficult to target by direct airway visualization. The code represents EBUS guidance for peripheral lesions, not EBUS-guided sampling of mediastinal or hilar lymph nodes.
Report 31654 only with a primary bronchoscopy procedure; examples of tissue-acquisition procedures that may be paired include transbronchial lung biopsy (31628) and transbronchial needle aspiration (31629), when performed. Documentation should identify the peripheral target and describe use of EBUS to localize or guide work on that lesion. CMS treats this as an add-on code, paid within the primary procedure's global period; it is not reported as a standalone service.
CMS billing rules for 31654
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU1.37 · 35%
- Practice expense (office) RVU2.43 · 62%
- Malpractice RVU0.13 · 3%
27.3K
Medicare services in 2024 · #1007 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.
31654 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$461.60
31629 reports transbronchial needle aspiration. Add 31654 when EBUS is used to guide work on a peripheral lung lesion.
$1,254.40
31652 covers EBUS-guided sampling of one or two mediastinal or hilar nodes; 31654 concerns EBUS guidance for peripheral pulmonary lesions.
$1,295.32
31653 covers EBUS-guided sampling of three or more mediastinal or hilar nodes; it is not the peripheral-lesion guidance service represented by 31654.
Compare 31654 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
Nebraska →
Office / nonfacility
$122.32
Facility
$56.34
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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 31654 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
3,659
- Code
- 31654
- Physician work
- 1.37
- Practice expense
- 2.43
- Malpractice
- 0.13
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.000 | 1.3700 |
| Practice expense | 2.43 | × 0.923 | 2.2429 |
| Malpractice | 0.13 | × 0.378 | 0.0491 |
| Total RVUs | 3.6620 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$122.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1 |
| Practice expense | 2.43 | 0.923 |
| Malpractice | 0.13 | 0.378 |
(1.37 × 1 + 2.43 × 0.923 + 0.13 × 0.378) × $33.4009 = $122.32
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1 |
| Practice expense | 0.29 | 0.923 |
| Malpractice | 0.13 | 0.378 |
(1.37 × 1 + 0.29 × 0.923 + 0.13 × 0.378) × $33.4009 = $56.34
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.
31654 billing questions
When is 31654 appropriate instead of 31652 or 31653?
Use 31654 for EBUS guidance of a peripheral pulmonary lesion. Codes 31652 and 31653 describe EBUS-guided sampling of mediastinal or hilar lymph nodes.
Can 31654 be reported by itself?
No. It is an add-on code and must be reported with a primary bronchoscopy procedure, such as an appropriate biopsy or aspiration service.
Can 31654 be paired with 31628 or 31629?
It may be paired with 31628 for transbronchial lung biopsy or 31629 for transbronchial needle aspiration when that procedure is performed on the peripheral lesion.
What documentation supports reporting 31654?
Document the peripheral pulmonary target and the use of endobronchial ultrasound to locate or guide the bronchoscopic work on that lesion.
Is 31654 reported once for each lesion?
The code covers EBUS guidance for peripheral lesion(s). Do not assume a separate unit for each lesion from the code description alone.
How does the add-on status affect payment?
CMS pays 31654 within the global period of the primary procedure, and it cannot be billed as a standalone procedure.
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.
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