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See a sample rate comparisonCPT 31628 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Lung Or Airway Biopsy, Exam Of The Lung And Airway With A Scope (Bronchoscopy). The Procedure Removes A Small Sample Of Lung Or Airway Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Respiratory System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 31628 |
| Medicaid Fee Schedule | View Medicaid rates for 31628 |
National average reimbursement for CPT 31628 by major payers:
$457.10
$492.97
$547.94
$307.54
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CPT 31628
5 of 25 sample ratesHigher to lower in this preview
Douglas Roth
Summit Medical Group, P.A.
$1,096.64Published rateNick Debitetto
Premier Health Associates, LLC
$498.61Published rateAhmed Seman
Community Primary Care PC
$329.66Published rateStuti Agrawal
$274.57Published rateDeepak Amin
$117.23Published rate
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See a sample payer proposalCPT 31628 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 31628 code is part of the Surgery services used for Surgical Procedures on the Respiratory System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 31628 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 31625-CPT | Moderate | Bronchoscopy Rigid Or Flexibl, Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed With Bronchial Or Endobronchial Biopsy(S) Single Or Multiple Sites |
| 31626-CPT | Moderate | Insert Scope Into Airway, Insertion Of A Scope (Bronchoscope) Into The Airway To Place A Contrast Material (Such As A Dye) Or A Marker (Such As Treated Cells). The Contrast Material Or Marker Highlights Specific Areas Of The Airway On Images Or Scans. |
| 31627-CPT | High | Bronchoscopy Rigid Or Flexibl, Bronchoscopy Rigid Or Flexible Including Fluoroscopic Guidance When Performed With Computer-Assisted Image-Guided Navigation (List Separately In Addition To Code For Primary Procedure[S]) |
| 31628-CPT | Moderate | Lung Or Airway Biopsy, Exam Of The Lung And Airway With A Scope (Bronchoscopy). The Procedure Removes A Small Sample Of Lung Or Airway Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 31628. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 31628 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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