How much does Medicare pay for CPT 31654?

Medicare allowed an average of $64.48 per service and paid $51.46 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $365.78, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 31654?

Exam of lung airways with diagnostic or therapeutic procedure on growths using an endoscope and ultrasound. It was billed 22,236 times to 21,804 Medicare beneficiaries by 736 providers in 2024.

Does 31654 pay differently in an office than a hospital?

Yes. The allowed amount averaged $73.87 in an office setting and $64.41 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 31654 most?

Pulmonary Disease, with 16,706 services from 560 clinicians. Next are Critical Care (Intensivists), Internal Medicine, Thoracic Surgery.

CPT 31654

Exam of lung airways with diagnostic or therapeutic procedure on growths using an endoscope and ultrasound

$64.48Medicare-allowed amount per service, averaged across 22,236 services

Providers submitted

$365.78

Asking price, not received

Medicare allowed

$64.48

The fee schedule figure

Medicare paid

$51.46

Balance is patient coinsurance

Providers submitted an average of $365.78 for this code and Medicare allowed $64.48 — 5.7× 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 $51.46 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $73.87
Hospital / facility: $64.41

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. 177 services were billed in an office setting and 22,059 in a facility.

Services: 22,236
Beneficiaries: 21,804
Providers billing it: 736
Total allowed: $1,433,777

What Medicare pays for CPT 31654

Across 22,236 services billed by 736 providers to 21,804 beneficiaries, Medicare allowed an average of $64.48 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 31654

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	16,706	16,390	$64.35	560
Critical Care (Intensivists)	2,821	2,760	$65.16	82
Internal Medicine	1,714	1,677	$63.83	54
Thoracic Surgery	718	702	$66.08	27
Cardiac Surgery	78	77	$62.65	3
General Surgery	69	69	$66.35	4
Hospitalist	49	49	$65.55	3
Undefined Physician type	48	47	$72.16	1
Allergy/ Immunology	20	20	$60.43	1
Nurse Practitioner	13	13	$54.86	1

31654 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	1,997	$64.03	$51.00	59
California	1,762	$68.34	$51.51	49
Illinois	1,654	$67.43	$51.01	48
Tennessee	1,304	$61.52	$51.12	36
Pennsylvania	1,138	$64.34	$51.09	38
Texas	991	$64.31	$51.14	43
New York	889	$71.46	$51.01	29
Indiana	866	$60.70	$51.09	29
Arizona	782	$63.73	$51.07	16
North Carolina	775	$61.86	$51.07	24
Massachusetts	708	$67.10	$50.95	22
Georgia	683	$62.74	$51.01	23
Missouri	631	$63.29	$50.91	18
Kentucky	575	$62.82	$51.32	21
Ohio	536	$63.72	$51.10	23
Maryland	527	$65.58	$51.10	14
Virginia	497	$65.10	$50.97	19
Wisconsin	436	$60.47	$50.51	16
Michigan	351	$65.62	$51.09	19
New Jersey	348	$69.04	$51.04	13
Minnesota	341	$63.10	$51.05	17
South Carolina	337	$62.00	$51.13	13
Washington	326	$63.87	$50.98	10
Colorado	318	$63.50	$50.86	11
Iowa	302	$60.40	$51.08	16
Alabama	282	$60.76	$50.96	10
Delaware	273	$64.26	$51.15	4
Oklahoma	266	$61.92	$50.64	8
Louisiana	255	$63.08	$51.01	9
Mississippi	250	$62.12	$51.21	11
Nebraska	240	$59.60	$51.10	10
Connecticut	239	$67.42	$51.07	6
District of Columbia	205	$71.36	$50.98	6
Kansas	193	$60.36	$51.20	8
Arkansas	133	$59.67	$51.15	4
Oregon	132	$65.49	$51.07	6
Utah	98	$62.66	$51.09	5
Nevada	81	$63.91	$50.93	2
Hawaii	79	$61.86	$51.65	3
West Virginia	71	$63.89	$50.31	3
New Hampshire	70	$63.88	$50.89	1
Idaho	67	$61.70	$51.25	2
Montana	54	$64.25	$51.04	2
North Dakota	38	$61.72	$51.04	2
New Mexico	34	$66.58	$51.09	2
Vermont	28	$61.98	$51.09	1
South Dakota	23	$61.87	$51.16	2
Alaska	21	$86.85	$51.11	1
Maine	16	$62.91	$51.15	1
Guam	14	$66.59	$51.09	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
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.