No office rate
31648 covers removal from the initial lobe; 31649 is added for each additional lobe treated.
On this page
CMS RVU26D · Effective 2026-10-01
31649 Valve removal Medicare reimbursement rates in Wyoming
Bronchoscopic removal of bronchial valves from each lobe beyond the first is reported as an add-on to initial-lobe valve removal. Compare 31649 office and facility rates across CMS payment localities in Wyoming.
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 31649 in Wyoming?
Wyoming 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
$70.60
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$60.58
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Bronchoscopy
About 31649: Additional-lobe bronchial valve removal
Bronchoscopic removal of bronchial valves from each lobe beyond the first is reported as an add-on to initial-lobe valve removal.
This code covers bronchoscopic removal of bronchial valves from an additional lobe after removal from the initial lobe. Interventional pulmonologists commonly perform the service in a hospital or ambulatory procedure setting for patients whose valves were placed as part of bronchoscopic lung volume reduction, often for emphysema. The work involves reaching the treated airway and removing valves in the additional lobe; the code counts lobes, not individual valves.
Report this add-on with 31648 for removal from the initial lobe, using one unit for each additional lobe treated. Documentation should identify the bronchoscopic removal, the lobes involved, and the initial-lobe removal service supporting the add-on. CMS lists this as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period.
CMS billing rules for 31649
- 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 RVU1.40 · 65%
- Practice expense (office) RVU0.61 · 28%
- Malpractice RVU0.14 · 7%
92
Medicare services in 2024 · #4940 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.
31649 compared with similar codes
Office rates for Wyoming, from the same CMS release.
Compare 31649 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
Wyoming** →
Office / nonfacility
$70.60
Facility
$60.58
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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 31649 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,655
- Code
- 31649
- Physician work
- 1.40
- Practice expense
- 0.61
- Malpractice
- 0.14
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.40 | × 1.000 | 1.4000 |
| Practice expense | 0.61 | × 1.000 | 0.6100 |
| Malpractice | 0.14 | × 0.740 | 0.1036 |
| Total RVUs | 2.1136 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$70.60
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.4 | 1 |
| Practice expense | 0.61 | 1 |
| Malpractice | 0.14 | 0.74 |
(1.4 × 1 + 0.61 × 1 + 0.14 × 0.74) × $33.4009 = $70.60
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.4 | 1 |
| Practice expense | 0.31 | 1 |
| Malpractice | 0.14 | 0.74 |
(1.4 × 1 + 0.31 × 1 + 0.14 × 0.74) × $33.4009 = $60.58
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.
31649 billing questions
When should 31649 be reported instead of 31648?
Use 31648 for removal from the initial lobe. Report 31649 for each additional lobe from which valves are removed during the service.
Is 31649 reported by valve or by lobe?
It is reported for each additional lobe, not for each individual valve removed within that lobe.
Can 31649 be billed without 31648?
No. It is an add-on code and is reported with 31648 for removal from the initial lobe.
What should the procedure note document?
Document bronchoscopic valve removal, the lobes treated, and which lobe was the initial removal service supporting 31648.
Is valve insertion coded with 31649?
No. Insertion is a different service; 31647 covers initial-lobe valve insertion and 31651 covers additional-lobe insertion.
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.
3,65231646,,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
3,65831653,,Bronch ebus samplng 3/> node,A,,4.84,36.58,,1.25,,0.47,41.89,6.56,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,