$375.87
The biopsy target determines the choice: 31625 is for airway tissue, while 31628 is for transbronchial lung tissue.
On this page
CMS RVU26D · Effective 2026-10-01
31625 Bronchoscopy biopsy Medicare reimbursement rates in Oklahoma
Reports bronchoscopic tissue sampling from an airway lesion or abnormal mucosa, such as when a pulmonologist biopsies a suspicious endobronchial finding. Compare 31625 office and facility rates across CMS payment localities in Oklahoma.
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 31625 in Oklahoma?
Oklahoma 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
$352.68
1 of 1 localities have a supported rate.
Payment area: Oklahoma
One mapped payment locality.
Facility setting
$135.24
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 procedures
About 31625: Bronchoscopic endobronchial tissue biopsy
Reports bronchoscopic tissue sampling from an airway lesion or abnormal mucosa, such as when a pulmonologist biopsies a suspicious endobronchial finding.
A pulmonologist or other qualified physician passes a bronchoscope into the airways and obtains tissue from an abnormal area, commonly with biopsy forceps. Typical targets include a visible bronchial mass, irregular mucosa, or another airway lesion requiring histologic evaluation. The procedure is commonly performed in a hospital bronchoscopy suite or an outpatient procedural setting, with sedation or anesthesia as clinically appropriate.
Choose this code for biopsy of airway tissue; transbronchial sampling of lung parenchyma is represented by a different code. The report should identify the biopsy site and describe the abnormality sampled and the tissue obtained. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed in the same session, endoscopy-family pricing applies. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 31625
- 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 RVU3.03 · 26%
- Practice expense (office) RVU8.17 · 71%
- Malpractice RVU0.30 · 3%
12.4K
Medicare services in 2024 · #1363 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.
31625 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
$259.70
31622 describes diagnostic bronchoscopy without the airway tissue biopsy reported with 31625.
$278.75
31623 collects cells by brushing; 31625 obtains tissue from an airway abnormality.
$455.51
31629 describes needle aspiration sampling, rather than the airway tissue biopsy reported with 31625.
Compare 31625 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
Oklahoma →
Office / nonfacility
$352.68
Facility
$135.24
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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 31625 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
3,634
- Code
- 31625
- Physician work
- 3.03
- Practice expense
- 8.17
- Malpractice
- 0.30
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.03 | × 1.000 | 3.0300 |
| Practice expense | 8.17 | × 0.893 | 7.2958 |
| Malpractice | 0.30 | × 0.777 | 0.2331 |
| Total RVUs | 10.5589 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Oklahoma$352.68
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.03 | 1 |
| Practice expense | 8.17 | 0.893 |
| Malpractice | 0.3 | 0.777 |
(3.03 × 1 + 8.17 × 0.893 + 0.3 × 0.777) × $33.4009 = $352.68
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.03 | 1 |
| Practice expense | 0.88 | 0.893 |
| Malpractice | 0.3 | 0.777 |
(3.03 × 1 + 0.88 × 0.893 + 0.3 × 0.777) × $33.4009 = $135.24
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.
31625 billing questions
When should this code be chosen instead of 31628?
Use this code for tissue taken from an airway lesion or mucosa. Code 31628 applies to transbronchial biopsy of lung tissue.
Can diagnostic bronchoscopy also be reported?
The airway inspection needed to locate and obtain the biopsy is part of the biopsy service. CMS endoscopy-family pricing applies when related endoscopies are performed together.
What documentation supports the biopsy?
Document the airway site, the abnormal finding sampled, and that tissue was obtained for evaluation. Distinguish an airway biopsy from sampling of lung parenchyma.
Should modifier 50 be appended for biopsies on both sides?
No. CMS identifies bilateral adjustment as inapplicable because the code descriptor or anatomy makes modifier 50 inappropriate.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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.
3,63131622,,Dx bronchoscope/wash,A,,2.47,5.68,,0.83,,0.30,8.45,3.60,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,63231623,,Dx bronchoscope/brush,A,,2.56,6.27,,0.77,,0.24,9.07,3.57,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,63331624,,Dx bronchoscope/lavage,A,,2.56,5.77,,0.82,,0.24,8.57,3.62,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,63431625,,Bronchoscopy w/biopsy(s),A,,3.03,8.17,,0.88,,0.30,11.50,4.21,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
3,63531626,,Bronchoscopy w/markers,A,,3.81,21.78,,1.08,,0.44,26.03,5.33,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,63631627,,Navigational bronchoscopy,A,,1.95,32.44,,0.40,,0.20,34.59,2.55,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,63731628,,Bronchoscopy/lung bx each,A,,3.46,8.44,,0.96,,0.33,12.23,4.75,0,000,0.00,0.00,0.00,3,0,1,0,0,9,31622,33.4009,09,0,99,0.00,0.00,0.00
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193