How much does Medicare pay for CPT 31623?

Medicare allowed an average of $15.29 per service and paid $12.08 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $772.57, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31623?

Exam of lung airways using an endoscope. It was billed 3,213 times to 3,128 Medicare beneficiaries by 121 providers in 2024.

Which specialty bills 31623 most?

Pulmonary Disease, with 2,463 services from 92 clinicians. Next are Critical Care (Intensivists), Internal Medicine, Thoracic Surgery.

CPT 31623

Exam of lung airways using an endoscope

$15.29Medicare-allowed amount per service, averaged across 3,213 services

Providers submitted

$772.57

Asking price, not received

Medicare allowed

$15.29

The fee schedule figure

Medicare paid

$12.08

Balance is patient coinsurance

Providers submitted an average of $772.57 for this code and Medicare allowed $15.29 — 50.5× 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 $12.08 (79%); the rest is the patient’s coinsurance and deductible.

Services: 3,213
Beneficiaries: 3,128
Providers billing it: 121
Total allowed: $49,127

What Medicare pays for CPT 31623

Across 3,213 services billed by 121 providers to 3,128 beneficiaries, Medicare allowed an average of $15.29 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 31623

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	2,463	2,397	$15.85	92
Critical Care (Intensivists)	356	348	$2.57	12
Internal Medicine	241	232	$29.34	10
Thoracic Surgery	63	63	$1.69	3
Cardiac Surgery	55	54	$0.36	2
General Surgery	23	23	$18.82	1
Allergy/ Immunology	12	11	$128.77	1

31623 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
North Carolina	502	$2.37	$1.70	19
Tennessee	474	$7.55	$6.48	13
Indiana	445	$14.49	$11.95	16
Wisconsin	264	$0.90	$0.19	12
Kansas	217	$0.30	$0.00	4
California	210	$20.54	$16.06	10
Alabama	199	$10.40	$8.57	9
Arkansas	161	$6.71	$4.96	5
Florida	129	$126.51	$96.98	5
Iowa	96	$1.10	$0.00	4
Nebraska	87	$2.05	$0.57	4
Virginia	75	$75.32	$0.00	3
Colorado	62	$0.14	$0.00	2
Georgia	53	$0.49	$0.00	2
Alaska	52	$1.53	$0.00	2
Arizona	52	$89.88	$77.41	3
North Dakota	47	$1.56	$0.00	2
Idaho	23	$24.55	$19.73	1
Minnesota	15	$0.63	$0.00	1
Kentucky	14	$0.66	$0.00	1
Connecticut	13	$76.70	$7.71	1
Texas	12	$119.76	$92.44	1
Missouri	11	$0.34	$11.48	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
31622Diagnostic exam of lung airway$108.89
31615Exam of windpipe and lung airways through permanent windpipe opening$145.91
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.