How much does Medicare pay for CPT 31622?

Medicare allowed an average of $108.89 per service and paid $85.98 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $810.07, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31622?

Diagnostic exam of lung airway using an endoscope. It was billed 9,253 times to 8,127 Medicare beneficiaries by 374 providers in 2024.

Does 31622 pay differently in an office than a hospital?

Yes. The allowed amount averaged $238.84 in an office setting and $102.52 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 31622 most?

Pulmonary Disease, with 3,025 services from 138 clinicians. Next are Thoracic Surgery, Otolaryngology, Internal Medicine.

CPT 31622

Diagnostic exam of lung airway using an endoscope

$108.89Medicare-allowed amount per service, averaged across 9,253 services

Providers submitted

$810.07

Asking price, not received

Medicare allowed

$108.89

The fee schedule figure

Medicare paid

$85.98

Balance is patient coinsurance

Providers submitted an average of $810.07 for this code and Medicare allowed $108.89 — 7.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $85.98 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $238.84
Hospital / facility: $102.52

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 432 services were billed in an office setting and 8,821 in a facility.

Services: 9,253
Beneficiaries: 8,127
Providers billing it: 374
Total allowed: $1,007,559

What Medicare pays for CPT 31622

Across 9,253 services billed by 374 providers to 8,127 beneficiaries, Medicare allowed an average of $108.89 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 31622

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	3,025	2,616	$124.20	138
Thoracic Surgery	2,717	2,617	$71.21	99
Otolaryngology	1,276	1,034	$107.30	49
Internal Medicine	821	630	$151.27	28
Cardiac Surgery	473	434	$74.37	18
Critical Care (Intensivists)	254	223	$124.56	16
Plastic and Reconstructive Surgery	154	129	$67.85	1
General Surgery	149	140	$74.21	8
Anesthesiology	107	62	$131.60	5
Ambulatory Surgical Center	94	89	$585.59	4
Nurse Practitioner	57	40	$101.78	1
Emergency Medicine	25	15	$132.55	1
Vascular Surgery	25	25	$68.59	1
Sleep Medicine	19	19	$134.53	1
Family Practice	15	15	$125.56	1

31622 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	1,556	$119.42	$89.12	61
Florida	940	$110.95	$83.07	43
Texas	914	$108.89	$84.54	25
New York	578	$124.04	$84.27	21
Tennessee	491	$84.11	$67.98	17
Mississippi	481	$118.53	$97.49	12
Ohio	383	$155.28	$125.12	19
Massachusetts	383	$97.02	$72.00	19
New Jersey	340	$78.34	$56.51	8
Illinois	252	$75.60	$55.79	8
Alabama	228	$95.15	$78.80	9
Pennsylvania	210	$100.36	$74.12	12
Arkansas	210	$126.34	$105.64	8
Kentucky	207	$91.47	$80.30	8
Michigan	196	$110.76	$81.55	11
Louisiana	185	$101.42	$82.38	9
Indiana	176	$93.51	$80.68	7
Arizona	173	$117.19	$96.37	8
New Hampshire	133	$75.33	$56.85	4
North Carolina	127	$113.00	$109.89	6
South Carolina	97	$240.63	$200.93	5
Missouri	97	$93.25	$74.52	4
Kansas	96	$117.96	$98.56	5
Georgia	93	$93.70	$77.23	6
Minnesota	87	$107.56	$86.36	6
Nevada	81	$75.06	$59.51	4
Washington	63	$69.52	$53.37	3
Maine	60	$69.55	$52.43	4
Maryland	58	$84.71	$58.73	3
Wisconsin	56	$86.77	$63.82	2
West Virginia	54	$109.34	$85.27	3
Virginia	48	$81.49	$64.12	2
Oklahoma	37	$119.15	$99.00	2
Oregon	36	$65.66	$50.61	2
Delaware	34	$69.33	$53.76	1
Nebraska	26	$116.87	$98.02	2
Colorado	23	$118.20	$99.42	2
Utah	18	$83.03	$59.32	1
Connecticut	13	$134.32	$101.40	1
South Dakota	13	$125.89	$101.27	1

Related codes

31624Irrigation and suction of lung airways to obtain cells$57.02
31628Biopsy of lobe of lung$77.25
31627Computer-assisted image-guided navigation of lung airways$93.76
31629Needle biopsy of windpipe cartilage$144.37
31645Aspiration of initial secretion of lung airway$83.67
31654Exam of lung airways$64.48
31652Exam of lung airways and sampling of lymph nodes$173.21
31653Exam of lung airways and sampling of lymph nodes$221.80
31615Exam of windpipe and lung airways through permanent windpipe opening$145.91
31623Exam of lung airways$15.29
31632Biopsy of lobe of lung$47.23
31625Biopsy of lung airway$72.30

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.