How much does Medicare pay for CPT 31627?

Medicare allowed an average of $93.76 per service and paid $74.64 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1915.54, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31627?

Computer-assisted image-guided navigation of lung airways using an endoscope. It was billed 26,730 times to 26,152 Medicare beneficiaries by 931 providers in 2024.

Does 31627 pay differently in an office than a hospital?

Yes. The allowed amount averaged $175.97 in an office setting and $92.99 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 31627 most?

Pulmonary Disease, with 19,430 services from 681 clinicians. Next are Critical Care (Intensivists), Internal Medicine, Thoracic Surgery.

CPT 31627

Computer-assisted image-guided navigation of lung airways using an endoscope

$93.76Medicare-allowed amount per service, averaged across 26,730 services

Providers submitted

$1915.54

Asking price, not received

Medicare allowed

$93.76

The fee schedule figure

Medicare paid

$74.64

Balance is patient coinsurance

Providers submitted an average of $1915.54 for this code and Medicare allowed $93.76 — 20.4× 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 $74.64 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $175.97
Hospital / facility: $92.99

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. 247 services were billed in an office setting and 26,483 in a facility.

Services: 26,730
Beneficiaries: 26,152
Providers billing it: 931
Total allowed: $2,506,205

What Medicare pays for CPT 31627

Across 26,730 services billed by 931 providers to 26,152 beneficiaries, Medicare allowed an average of $93.76 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 31627

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	19,430	19,026	$93.54	681
Critical Care (Intensivists)	3,360	3,280	$94.48	103
Internal Medicine	2,089	2,045	$92.43	68
Thoracic Surgery	1,400	1,367	$96.85	60
Cardiac Surgery	179	172	$90.49	6
Undefined Physician type	80	73	$104.24	1
General Surgery	71	69	$95.99	4
Hospitalist	38	38	$93.20	3
Cardiology	28	27	$101.92	2
Allergy/ Immunology	24	24	$87.37	1
Nurse Practitioner	16	16	$78.81	1
Emergency Medicine	15	15	$93.55	1

31627 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	2,443	$106.32	$78.46	70
Florida	2,344	$93.40	$73.29	76
Illinois	1,680	$97.59	$73.21	50
Texas	1,586	$92.53	$73.29	68
Tennessee	1,388	$88.24	$73.57	41
New York	1,188	$102.89	$73.24	39
Pennsylvania	1,183	$91.45	$73.49	43
North Carolina	1,115	$88.92	$72.19	35
Indiana	948	$86.94	$73.44	34
Arizona	925	$91.43	$73.26	19
Georgia	854	$90.69	$72.68	32
Maryland	770	$94.88	$73.62	22
Kentucky	730	$90.42	$73.61	28
Massachusetts	713	$96.16	$73.39	23
Ohio	698	$91.69	$73.42	29
South Carolina	566	$91.88	$73.25	20
Virginia	559	$92.70	$72.94	22
Missouri	524	$90.81	$73.42	17
Wisconsin	467	$86.66	$73.06	20
Michigan	448	$94.87	$73.44	24
New Jersey	436	$100.05	$73.12	20
Minnesota	411	$90.65	$73.15	21
Washington	382	$91.64	$73.57	13
Colorado	314	$90.68	$72.88	12
Alabama	313	$87.16	$73.13	12
Mississippi	308	$89.60	$73.08	13
Iowa	302	$87.10	$73.20	14
Kansas	301	$87.97	$73.61	10
Oklahoma	300	$89.00	$73.62	11
District of Columbia	269	$101.60	$73.36	7
Louisiana	257	$90.87	$73.39	9
Connecticut	255	$97.06	$73.47	8
Delaware	254	$93.15	$73.26	7
Nebraska	228	$85.74	$72.07	10
Oregon	150	$93.14	$72.97	7
Nevada	149	$91.28	$72.73	6
Arkansas	138	$85.54	$73.58	4
Hawaii	108	$89.63	$72.03	4
Utah	104	$90.19	$73.40	5
Montana	82	$92.86	$72.91	3
New Hampshire	80	$91.97	$73.25	2
Idaho	77	$87.45	$72.85	3
West Virginia	77	$91.60	$72.46	3
North Dakota	72	$88.91	$72.53	4
Alaska	57	$124.12	$73.54	2
South Dakota	53	$88.16	$73.60	2
New Mexico	50	$95.32	$72.02	3
Vermont	41	$91.04	$73.51	2
Maine	18	$90.24	$73.60	1
Rhode Island	15	$93.55	$73.44	1

Related codes

31624Irrigation and suction of lung airways to obtain cells$57.02
31628Biopsy of lobe of lung$77.25
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
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.