Billing code 31626: Fiducial placementMedicare rate & RVUs in Texas
Reports bronchoscopic placement of one or more fiducial markers near a lung target for image-guided radiation treatment or lesion localization.
Medicare pays $802.91–$910.20 for 31626 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 31626 covers
During flexible or rigid bronchoscopy, a pulmonologist or thoracic surgeon places one or more radiopaque fiducial markers in or near a pulmonary target. The markers provide a reference for later image-guided treatment, commonly stereotactic radiation, or for localizing a small lung lesion. The procedure is typically performed in a hospital bronchoscopy suite or operating room, often with imaging guidance and anesthesia support.
Report 31626 for marker placement, whether one or several markers are placed. Documentation should identify the target, marker number and locations, bronchoscopic approach, and clinical purpose. Navigation to a peripheral target or tissue sampling may also be performed and evaluated under the applicable bronchoscopy codes. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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.
Where 31626 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$802.91 to $910.20
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $910.20 | $178.70 |
| Beaumont | $802.91 | $173.74 |
| Brazoria | $860.66 | $175.49 |
| Dallas | $865.57 | $176.94 |
| Fort Worth | $858.49 | $176.77 |
| Galveston | $862.82 | $176.26 |
| Houston | $870.88 | $184.32 |
| Rest Of Texas | $830.90 | $174.76 |
How the 31626 rate is calculated
Each of 31626’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 31626
RVUs × geographic indexes × conversion factor
Work3.81
3.81 RVUs× 1.000 GPCI
Practice expense21.78
21.78 RVUs× 1.000 GPCI
Malpractice0.44
0.44 RVUs× 1.000 GPCI
Adjusted RVUs
26.0300
Conversion factor
$33.4009
Medicare rate
$869.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 31626
The CMS indicators that decide how 31626 is paid alongside other services.
CMS payment indicators · 31626
Fiducial placement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
31626 without 51 · national office
$869.43
Fiducial placement
31626-51 · Second procedure: 50%
$434.72
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
31626 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31627Navigational bronchoscopy
- Use 31627 for bronchoscopic navigation to a target. Use 31626 for placing fiducial markers; a procedure may include both services.
- 31628Lung biopsy
- 31628 describes transbronchial lung biopsy, which obtains tissue. 31626 places markers for later localization or treatment.
- 31625Bronchoscopy biopsy
- 31625 describes bronchoscopic biopsy of an endobronchial or other airway lesion. 31626 describes marker deployment, not tissue sampling.
31626 billing questions
Is 31626 reported once per marker?
No. The code includes placement of a single marker or multiple markers; document how many were placed and their locations.
How is 31626 different from navigational bronchoscopy?
31626 represents deployment of fiducial markers. 31627 represents navigational guidance to a bronchoscopic target; both services may be performed during the same procedure.
Can lung biopsy be reported with marker placement?
A distinct lung biopsy may be performed during the same bronchoscopy and considered under the applicable biopsy code. Document the tissue-sampling service separately from marker deployment.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How does Medicare pay when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and the other procedures are paid at 50% under the standard multiple procedure reduction.
Can modifier 50 be used when markers are placed on both sides?
No. CMS identifies modifier 50 as inappropriate for this descriptor and anatomy.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 31626 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →