CPT 31625
Global 000 ActiveBronchoscopy w/biopsy(s)
CPT 31625 Billing & Documentation Guide
CPT code 31625 (Bronchoscopy w/biopsy(s)) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.03, a non-facility practice expense RVU of 8.17, and a malpractice RVU of 0.3, a total non-facility RVU of 11.5 and facility RVU of 4.21. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $396.64, though rates vary from $340.77 to $511.21 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 31625, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 31625 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 31625 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 31625
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.03 | 3.03 |
| Practice Expense RVU | 8.17 | 0.88 |
| Malpractice RVU | 0.3 | 0.3 |
| Total RVU | 11.5 | 4.21 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 31625
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $433.16 | $145.04 | $407.38 - $511.21 | 29 |
| Florida | $394.5 | $150.2 | $377.14 - $410.62 | 3 |
| Georgia | $373.68 | $141.39 | $356.56 - $390.79 | 2 |
| Illinois | $384.38 | $149.11 | $366.01 - $399.92 | 4 |
| Michigan | $371.55 | $142.91 | $361.66 - $381.43 | 2 |
| North Carolina | $362.21 | $135.03 | $362.21 - $362.21 | 1 |
| New York | $424.06 | $152.42 | $367.49 - $450.75 | 5 |
| Ohio | $360.45 | $138.14 | $360.45 - $360.45 | 1 |
| Pennsylvania | $380.12 | $141.62 | $361.18 - $399.05 | 2 |
| Texas | $379.73 | $140.01 | $358.84 - $399 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 31625
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 31625 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00520 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0251T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0253T | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 31625
What does CPT code 31625 mean? +
CPT code 31625 represents: Bronchoscopy w/biopsy(s). It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 31625? +
The 2026 Medicare national average non-facility payment for CPT 31625 is $396.64. Rates range from $340.77 to $511.21 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 31625? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 31625? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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