How much does Medicare pay for CPT 31652?

Medicare allowed an average of $173.21 per service and paid $136.65 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1919.98, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31652?

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes. It was billed 16,925 times to 16,712 Medicare beneficiaries by 768 providers in 2024.

Does 31652 pay differently in an office than a hospital?

Yes. The allowed amount averaged $154.63 in an office setting and $173.32 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 31652 most?

Pulmonary Disease, with 12,318 services from 569 clinicians. Next are Critical Care (Intensivists), Internal Medicine, Thoracic Surgery.

CPT 31652

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes

$173.21Medicare-allowed amount per service, averaged across 16,925 services

Providers submitted

$1919.98

Asking price, not received

Medicare allowed

$173.21

The fee schedule figure

Medicare paid

$136.65

Balance is patient coinsurance

Providers submitted an average of $1919.98 for this code and Medicare allowed $173.21 — 11.1× 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 $136.65 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $154.63
Hospital / facility: $173.32

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 102 services were billed in an office setting and 16,823 in a facility.

Services: 16,925
Beneficiaries: 16,712
Providers billing it: 768
Total allowed: $2,931,579

What Medicare pays for CPT 31652

Across 16,925 services billed by 768 providers to 16,712 beneficiaries, Medicare allowed an average of $173.21 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 31652

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	12,318	12,161	$169.32	569
Critical Care (Intensivists)	2,041	2,017	$162.80	81
Internal Medicine	1,500	1,477	$159.16	57
Thoracic Surgery	833	828	$197.20	46
General Surgery	46	45	$200.32	3
Ambulatory Surgical Center	44	43	$1688.79	3
Cardiac Surgery	34	33	$201.80	2
Hospitalist	32	32	$146.36	2
Sleep Medicine	24	23	$226.01	2
Undefined Physician type	19	19	$194.01	1
Emergency Medicine	19	19	$213.19	1
Allergy/ Immunology	15	15	$153.25	1

31652 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	1,303	$177.33	$128.59	52
Florida	1,273	$163.86	$126.26	60
Illinois	1,172	$175.62	$131.45	42
Texas	929	$168.24	$131.31	43
Pennsylvania	916	$160.03	$128.09	39
New York	862	$196.95	$139.48	40
North Carolina	669	$194.43	$157.98	26
Tennessee	645	$150.96	$124.06	25
Virginia	554	$170.63	$133.53	26
Indiana	536	$146.58	$122.61	29
Ohio	512	$160.64	$128.70	27
New Jersey	484	$194.16	$144.44	22
Arizona	480	$180.51	$142.77	20
Georgia	474	$153.44	$121.78	19
Missouri	463	$168.77	$135.48	21
Kentucky	458	$153.31	$123.14	22
Maryland	456	$179.62	$137.14	19
Massachusetts	415	$173.26	$130.77	19
Minnesota	362	$177.62	$141.99	21
South Carolina	313	$162.61	$128.07	14
Kansas	300	$170.40	$143.87	14
Michigan	295	$179.27	$136.76	18
Wisconsin	285	$233.67	$195.54	12
Washington	256	$156.06	$121.88	11
Arkansas	238	$190.29	$157.71	9
Iowa	238	$148.04	$125.03	15
Colorado	201	$156.81	$122.99	10
Nebraska	179	$166.14	$141.19	9
Delaware	174	$148.80	$119.70	7
Mississippi	150	$176.50	$141.61	10
Connecticut	147	$171.62	$125.49	6
Oklahoma	133	$167.70	$136.87	6
Alabama	129	$175.99	$144.27	7
Louisiana	123	$178.04	$144.00	7
District of Columbia	119	$179.97	$126.90	4
Nevada	98	$161.79	$130.16	6
South Dakota	81	$181.65	$151.13	5
Hawaii	79	$145.56	$112.56	3
Oregon	73	$148.48	$109.42	3
West Virginia	66	$178.18	$139.77	3
Montana	43	$158.53	$119.02	2
Utah	42	$196.06	$154.82	3
New Hampshire	40	$145.35	$113.24	2
North Dakota	40	$179.19	$144.98	3
Idaho	38	$155.21	$127.62	2
Alaska	37	$928.65	$510.93	2
Rhode Island	19	$213.19	$166.83	1
Vermont	14	$167.68	$138.17	1
New Mexico	12	$191.58	$154.30	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
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.