How much does Medicare pay for CPT 31653?

Medicare allowed an average of $221.80 per service and paid $175.16 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2162.70, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31653?

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes. It was billed 13,900 times to 13,763 Medicare beneficiaries by 545 providers in 2024.

Does 31653 pay differently in an office than a hospital?

Yes. The allowed amount averaged $222.04 in an office setting and $221.80 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 31653 most?

Pulmonary Disease, with 10,350 services from 402 clinicians. Next are Critical Care (Intensivists), Internal Medicine, Thoracic Surgery.

CPT 31653

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes

$221.80Medicare-allowed amount per service, averaged across 13,900 services

Providers submitted

$2162.70

Asking price, not received

Medicare allowed

$221.80

The fee schedule figure

Medicare paid

$175.16

Balance is patient coinsurance

Providers submitted an average of $2162.70 for this code and Medicare allowed $221.80 — 9.8× 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 $175.16 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $222.04
Hospital / facility: $221.80

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. 136 services were billed in an office setting and 13,764 in a facility.

Services: 13,900
Beneficiaries: 13,763
Providers billing it: 545
Total allowed: $3,083,020

What Medicare pays for CPT 31653

Across 13,900 services billed by 545 providers to 13,763 beneficiaries, Medicare allowed an average of $221.80 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 31653

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	10,350	10,250	$218.61	402
Critical Care (Intensivists)	1,687	1,665	$225.26	68
Internal Medicine	1,062	1,055	$212.21	42
Thoracic Surgery	612	606	$230.70	24
Cardiac Surgery	70	70	$153.73	2
General Surgery	54	54	$225.23	4
Ambulatory Surgical Center	28	28	$1529.30	1
Nurse Practitioner	20	20	$195.33	1
Cardiology	17	15	$244.95	1

31653 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	1,480	$209.88	$156.00	48
Florida	1,142	$229.05	$180.59	33
Tennessee	789	$183.74	$151.57	27
Pennsylvania	751	$218.59	$173.32	32
Maryland	704	$236.82	$180.29	23
Texas	658	$225.42	$175.35	28
Arizona	637	$222.47	$170.94	18
Massachusetts	592	$223.96	$169.41	21
Ohio	581	$222.01	$178.36	31
Illinois	569	$227.13	$171.71	22
Michigan	385	$233.59	$180.56	18
New York	381	$237.12	$171.03	23
Wisconsin	366	$311.90	$254.05	18
District of Columbia	316	$254.19	$178.48	6
Georgia	307	$223.70	$178.11	13
Indiana	294	$200.58	$168.66	14
Missouri	276	$222.82	$176.80	11
North Carolina	262	$216.43	$175.67	13
Washington	252	$217.40	$162.11	13
Connecticut	245	$242.38	$178.51	7
Minnesota	238	$183.07	$144.78	9
Virginia	227	$236.94	$179.04	11
South Carolina	196	$217.42	$172.29	6
Kentucky	191	$204.55	$169.38	9
Louisiana	180	$221.76	$181.51	7
Mississippi	177	$214.13	$180.01	9
Colorado	158	$213.87	$165.80	7
Delaware	149	$210.89	$165.65	3
Nebraska	143	$211.69	$178.75	6
Iowa	129	$168.21	$143.61	5
New Hampshire	103	$202.09	$160.75	3
Kansas	99	$216.44	$177.28	4
Alabama	93	$208.57	$176.81	5
New Jersey	92	$247.68	$177.57	5
Oregon	86	$231.88	$179.75	5
Nevada	73	$195.04	$153.35	2
South Dakota	72	$222.24	$180.37	4
Arkansas	67	$215.72	$184.60	3
Idaho	61	$222.70	$185.00	2
Vermont	59	$222.02	$183.13	3
Utah	58	$220.13	$180.60	3
North Dakota	53	$169.56	$140.89	3
Oklahoma	34	$219.05	$166.96	2
Maine	33	$229.23	$186.42	2
New Mexico	32	$242.43	$186.50	2
Montana	32	$227.18	$180.29	1
Rhode Island	27	$238.53	$172.51	2
Alaska	23	$239.01	$139.93	1
West Virginia	15	$234.90	$180.38	1
Hawaii	13	$179.47	$143.30	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
31652Exam of lung airways and sampling of lymph nodes$173.21
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.