CPT 31626
Global 000 ActiveBronchoscopy w/markers
CPT 31626 Billing & Documentation Guide
CPT code 31626 (Bronchoscopy w/markers) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.81, a non-facility practice expense RVU of 21.78, and a malpractice RVU of 0.44, a total non-facility RVU of 26.03 and facility RVU of 5.33. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $901.65, though rates vary from $759.72 to $1198.15 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 31626, 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 31626 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 31626 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 31626
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.81 | 3.81 |
| Practice Expense RVU | 21.78 | 1.08 |
| Malpractice RVU | 0.44 | 0.44 |
| Total RVU | 26.03 | 5.33 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 31626
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 | $1000.59 | $182.47 | $934.61 - $1198.15 | 29 |
| Florida | $885.76 | $192.06 | $844.81 - $921.72 | 3 |
| Georgia | $839.04 | $179.45 | $793.68 - $884.4 | 2 |
| Illinois | $858.71 | $190.64 | $814.41 - $901.3 | 4 |
| Michigan | $831.04 | $181.82 | $808.03 - $854.05 | 2 |
| North Carolina | $815.38 | $170.3 | $815.38 - $815.38 | 1 |
| New York | $964.84 | $193.51 | $828.69 - $1027.66 | 5 |
| Ohio | $806.25 | $175.01 | $806.25 - $806.25 | 1 |
| Pennsylvania | $856.67 | $179.45 | $808.96 - $904.38 | 2 |
| Texas | $857.8 | $177.12 | $802.91 - $910.2 | 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 31626
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 31626 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 |
| 00528 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00529 | 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 | Standards of medical/surgical practice |
| 0216T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 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 | CPT Separate procedure definition |
| 0276T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
Frequently Asked Questions, CPT 31626
What does CPT code 31626 mean? +
CPT code 31626 represents: Bronchoscopy w/markers. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 31626? +
The 2026 Medicare national average non-facility payment for CPT 31626 is $901.65. Rates range from $759.72 to $1198.15 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 31626? +
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 31626? +
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 1, 2026.
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