$69.30
31648 covers removal from the initial lobe; 31649 covers removal from each additional lobe.
On this page
CMS RVU26D · Effective 2026-10-01
31648 Valve removal Medicare reimbursement rates in Vermont
Reports bronchoscopic removal of one or more previously placed bronchial valves from the first treated lobe, including removal performed during therapeutic airway management. Compare 31648 office and facility rates across CMS payment localities in Vermont.
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 31648 in Vermont?
Vermont 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
No supported rate
Facility setting
$170.56
1 of 1 localities have a supported rate.
Payment area: Vermont
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 endoscopy
About 31648: Bronchoscopic bronchial valve removal
Reports bronchoscopic removal of one or more previously placed bronchial valves from the first treated lobe, including removal performed during therapeutic airway management.
An interventional pulmonologist or thoracic surgeon uses a flexible or rigid bronchoscope to remove bronchial valve(s) from the initial lobe in which valves are being removed. These valves may have been placed as part of bronchoscopic lung-volume-reduction treatment for emphysema. The service is typically performed in a facility bronchoscopy suite or operating room, with the bronchoscopist visualizing the airway and retrieving the valve device or devices from that lobe.
Report 31648 for the initial lobe; when valve removal extends to another lobe, report the additional-lobe service separately with 31649. The procedure note should identify the lobe treated and document bronchoscopic removal of the valve(s). Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Do not use modifier 50 for bilateral reporting. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
CMS billing rules for 31648
- 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 RVU3.85 · 73%
- Practice expense (office) RVU1.08 · 20%
- Malpractice RVU0.37 · 7%
627
Medicare services in 2024 · #3355 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.
31648 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
31647 reports initial-lobe bronchial valve placement. Choose 31648 when the service is removal rather than placement.
No office rate
31638 addresses revision of a bronchial stent, not removal of bronchial valves. The device and service performed determine the code.
Compare 31648 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
Vermont →
Office / nonfacility
Unavailable
Facility
$170.56
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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 31648 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,654
- Code
- 31648
- Physician work
- 3.85
- Practice expense
- 1.08
- Malpractice
- 0.37
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.85 | × 1.000 | 3.8500 |
| Practice expense | 1.08 | × 0.990 | 1.0692 |
| Malpractice | 0.37 | × 0.506 | 0.1872 |
| Total RVUs | 5.1064 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$170.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.85 | 1 |
| Practice expense | 1.08 | 0.99 |
| Malpractice | 0.37 | 0.506 |
(3.85 × 1 + 1.08 × 0.99 + 0.37 × 0.506) × $33.4009 = $170.56
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.
31648 billing questions
When is 31648 selected instead of 31649?
Use 31648 for valve removal from the initial lobe. Use 31649 for removal from each additional lobe.
Does this code describe valve placement?
No. It describes bronchoscopic removal of previously placed bronchial valves. Code 31647 addresses initial-lobe valve placement, while 31651 addresses placement in an additional lobe.
Should modifier 50 be appended when valves are removed from both lungs?
No. The CMS bilateral adjustment does not apply to 31648, and modifier 50 is inappropriate for this service.
What documentation supports reporting 31648?
Document bronchoscopic removal of bronchial valve(s) and identify the lobe treated as the initial lobe for removal. Document additional lobes separately when reporting 31649.
How are related endoscopies handled when performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 31648. 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.
3,65131645,,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
3,65631651,,Bronchial valve addl insert,A,,1.54,0.64,,0.32,,0.15,2.33,2.01,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,65731652,,Bronch ebus samplng 1/2 node,A,,4.35,35.80,,1.15,,0.43,40.58,5.93,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817