How much does Medicare pay for CPT 31629?

Medicare allowed an average of $144.37 per service and paid $114.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1314.02, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31629?

Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope. It was billed 24,498 times to 24,035 Medicare beneficiaries by 867 providers in 2024.

Does 31629 pay differently in an office than a hospital?

Yes. The allowed amount averaged $171.87 in an office setting and $144.11 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 31629 most?

Pulmonary Disease, with 17,794 services from 640 clinicians. Next are Critical Care (Intensivists), Internal Medicine, Thoracic Surgery.

CPT 31629

Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope

$144.37Medicare-allowed amount per service, averaged across 24,498 services

Providers submitted

$1314.02

Asking price, not received

Medicare allowed

$144.37

The fee schedule figure

Medicare paid

$114.75

Balance is patient coinsurance

Providers submitted an average of $1314.02 for this code and Medicare allowed $144.37 — 9.1× 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 $114.75 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $171.87
Hospital / facility: $144.11

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. 234 services were billed in an office setting and 24,264 in a facility.

Services: 24,498
Beneficiaries: 24,035
Providers billing it: 867
Total allowed: $3,536,776

What Medicare pays for CPT 31629

Across 24,498 services billed by 867 providers to 24,035 beneficiaries, Medicare allowed an average of $144.37 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 31629

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	17,794	17,471	$142.74	640
Critical Care (Intensivists)	3,296	3,227	$151.49	101
Internal Medicine	2,023	1,979	$142.20	69
Thoracic Surgery	990	971	$145.62	40
Cardiac Surgery	178	171	$128.95	6
General Surgery	55	55	$129.94	4
Undefined Physician type	54	53	$198.23	1
Hospitalist	30	30	$162.44	2
Allergy/ Immunology	22	22	$148.90	1
Nurse Practitioner	22	22	$92.33	1
Emergency Medicine	17	17	$107.00	1
Ambulatory Surgical Center	17	17	$764.66	1

31629 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
Florida	2,159	$143.36	$89.01	69
California	2,143	$161.97	$88.35	67
Texas	1,534	$147.09	$97.36	63
Illinois	1,438	$147.57	$84.52	40
Tennessee	1,331	$123.41	$77.16	40
Pennsylvania	1,171	$142.54	$86.91	38
North Carolina	1,059	$148.82	$98.82	34
New York	986	$161.89	$95.69	39
Indiana	899	$144.71	$94.20	29
Ohio	812	$128.05	$84.95	32
Kentucky	768	$149.21	$93.63	29
Georgia	732	$142.74	$86.54	28
Maryland	666	$129.47	$80.65	22
Missouri	659	$145.54	$98.08	22
Massachusetts	614	$140.48	$82.34	20
Virginia	585	$156.03	$95.30	22
South Carolina	514	$150.64	$92.85	19
Arizona	485	$147.06	$89.32	15
Wisconsin	474	$141.96	$97.16	21
Washington	428	$131.07	$72.27	16
Michigan	424	$138.31	$87.15	22
Minnesota	389	$115.49	$70.10	18
New Jersey	333	$171.27	$99.24	15
District of Columbia	302	$126.29	$74.63	7
Iowa	298	$153.95	$87.03	15
Oklahoma	297	$166.50	$123.59	10
Kansas	285	$151.52	$100.04	9
Colorado	280	$153.08	$92.31	11
Alabama	263	$140.74	$102.86	9
Mississippi	258	$137.00	$95.58	10
Connecticut	230	$144.25	$82.66	8
Louisiana	228	$126.47	$84.78	9
Delaware	204	$131.24	$67.11	5
Nevada	135	$123.90	$74.65	5
Nebraska	128	$125.32	$82.07	5
Oregon	123	$150.59	$86.92	5
Hawaii	106	$94.84	$54.31	4
Idaho	97	$135.04	$94.02	4
West Virginia	90	$150.58	$98.45	4
Montana	77	$152.83	$96.12	4
Utah	68	$141.15	$99.86	3
Arkansas	66	$153.47	$105.30	3
South Dakota	64	$92.40	$89.50	3
New Hampshire	60	$155.94	$70.96	1
Alaska	57	$228.37	$90.43	2
North Dakota	44	$89.27	$55.60	2
Vermont	41	$109.17	$76.18	2
Maine	40	$98.58	$72.98	3
New Mexico	37	$157.13	$99.13	3
Rhode Island	17	$107.00	$83.83	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
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.