How much does Medicare pay for CPT 31645?

Medicare allowed an average of $83.67 per service and paid $66.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $794.55, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31645?

Aspiration of initial secretion of lung airway using an endoscope. It was billed 23,040 times to 20,503 Medicare beneficiaries by 742 providers in 2024.

Does 31645 pay differently in an office than a hospital?

Yes. The allowed amount averaged $24.11 in an office setting and $84.01 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 31645 most?

Pulmonary Disease, with 15,420 services from 491 clinicians. Next are Critical Care (Intensivists), Internal Medicine, Thoracic Surgery.

CPT 31645

Aspiration of initial secretion of lung airway using an endoscope

$83.67Medicare-allowed amount per service, averaged across 23,040 services

Providers submitted

$794.55

Asking price, not received

Medicare allowed

$83.67

The fee schedule figure

Medicare paid

$66.31

Balance is patient coinsurance

Providers submitted an average of $794.55 for this code and Medicare allowed $83.67 — 9.5× 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 $66.31 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $24.11
Hospital / facility: $84.01

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 131 services were billed in an office setting and 22,909 in a facility.

Services: 23,040
Beneficiaries: 20,503
Providers billing it: 742
Total allowed: $1,927,757

What Medicare pays for CPT 31645

Across 23,040 services billed by 742 providers to 20,503 beneficiaries, Medicare allowed an average of $83.67 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 31645

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	15,420	13,759	$82.36	491
Critical Care (Intensivists)	3,409	3,021	$91.15	118
Internal Medicine	1,997	1,824	$76.47	64
Thoracic Surgery	1,535	1,407	$69.23	47
Family Practice	223	86	$133.51	2
Cardiac Surgery	97	81	$73.39	2
General Surgery	77	74	$73.82	3
Sleep Medicine	65	57	$95.92	2
Hospitalist	34	33	$136.44	2
General Practice	27	18	$142.56	1
Nurse Practitioner	25	23	$113.72	1
Undefined Physician type	19	15	$90.84	1
Ambulatory Surgical Center	18	17	$914.69	1
Diagnostic Radiology	16	14	$68.88	1
Nephrology	15	14	$133.15	1

31645 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	4,180	$81.60	$57.09	98
Florida	2,325	$90.67	$68.16	65
Georgia	1,507	$89.03	$69.44	38
Illinois	1,369	$78.66	$58.21	40
Texas	1,263	$87.33	$65.09	42
New York	1,175	$82.26	$54.72	36
Massachusetts	941	$67.28	$47.46	30
Kentucky	884	$101.44	$81.34	33
Ohio	637	$89.74	$70.64	31
Mississippi	629	$125.50	$101.38	19
Arkansas	603	$119.44	$98.96	21
Pennsylvania	573	$72.23	$52.52	24
Maryland	495	$68.52	$49.93	17
Washington	477	$48.88	$34.55	11
Arizona	460	$63.53	$47.44	15
Indiana	445	$87.28	$71.07	16
South Carolina	406	$92.85	$73.25	15
Missouri	391	$96.19	$76.50	19
Tennessee	360	$54.48	$42.34	10
Wisconsin	332	$53.40	$40.78	14
Virginia	320	$53.71	$38.15	7
Michigan	282	$71.86	$54.41	12
Nevada	276	$117.05	$93.44	13
Alabama	274	$92.08	$76.91	10
New Jersey	266	$100.39	$73.55	12
North Carolina	254	$73.66	$57.56	10
Oklahoma	244	$87.92	$71.54	10
Iowa	232	$64.07	$50.16	10
Minnesota	222	$70.60	$54.95	7
Colorado	219	$72.40	$55.30	9
Kansas	142	$65.69	$52.82	8
New Hampshire	139	$78.02	$56.75	4
Nebraska	121	$125.90	$103.13	7
Delaware	107	$51.41	$36.47	2
New Mexico	86	$30.91	$21.67	3
Alaska	85	$93.69	$51.61	4
Connecticut	70	$80.74	$57.14	5
Louisiana	64	$42.02	$31.10	3
Oregon	38	$132.58	$102.25	3
Vermont	26	$31.44	$21.55	1
Utah	25	$38.22	$26.68	2
South Dakota	23	$124.72	$100.88	2
Guam	21	$145.13	$104.34	1
Rhode Island	20	$121.04	$90.83	1
North Dakota	17	$137.22	$109.21	1
Idaho	15	$61.33	$48.26	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
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.