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Official Description

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A bronchoscopy, as described by CPT® Code 31640, is a medical procedure that involves the insertion of a bronchoscope, which can be either rigid or flexible, through the patient's nose or mouth. This instrument is advanced into the oropharynx, allowing for a thorough examination of the airway structures. The procedure may include fluoroscopic guidance, which utilizes real-time imaging to assist in navigating the bronchoscope and ensuring accurate placement. During the bronchoscopy, the physician examines the oropharynx and visualizes the vocal cords, assessing them for any abnormalities. The bronchoscope is then further advanced into the trachea, where the airway is inspected, and subsequently into each mainstem bronchus. If a rigid bronchoscope is employed, a telescope or flexible bronchoscope can be inserted through it to enhance visualization of the distal segments of the mainstem bronchi. The primary objective of this procedure is to excise a tumor that has been identified during the examination. Once the tumor is visualized, specialized surgical instruments and a suction catheter are introduced through the bronchoscope to facilitate the excision of the tumor, ensuring that the procedure is performed safely and effectively.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 31640 is indicated for various clinical scenarios where the excision of a tumor within the airway is necessary. The following conditions may warrant the performance of this procedure:

  • Presence of a Tumor The procedure is indicated when a tumor is identified in the airway, necessitating removal for diagnostic or therapeutic purposes.
  • Abnormal Findings on Imaging If imaging studies, such as CT scans or X-rays, reveal suspicious masses or lesions in the trachea or bronchi, bronchoscopy may be performed to further evaluate and excise these abnormalities.
  • Symptoms of Airway Obstruction Patients presenting with symptoms such as persistent cough, hemoptysis (coughing up blood), or difficulty breathing may require bronchoscopy to assess and remove obstructive tumors.

2. Procedure

The procedure for CPT® Code 31640 involves several critical steps to ensure the successful excision of the tumor. Each step is detailed as follows:

  • Step 1: Preparation and Anesthesia The patient is prepared for the procedure, which may involve administering local anesthesia or sedation to ensure comfort during the bronchoscopy. The healthcare team ensures that all necessary equipment is ready and that the patient is in a suitable position for the procedure.
  • Step 2: Insertion of the Bronchoscope A rigid or flexible bronchoscope is inserted through the patient's nose or mouth and advanced into the oropharynx. The physician carefully navigates the bronchoscope to visualize the airway structures, including the vocal cords and trachea.
  • Step 3: Examination of the Airway The bronchoscope is advanced into the trachea and then into each mainstem bronchus. The physician examines these areas for any abnormalities, noting the presence of tumors or other lesions that may require intervention.
  • Step 4: Visualization of the Tumor If a tumor is identified, the physician may use a telescope or flexible bronchoscope inserted through the rigid bronchoscope to enhance visualization of the distal segments of the mainstem bronchi, ensuring a clear view of the tumor.
  • Step 5: Tumor Excision Once the tumor is adequately visualized, a suction catheter and appropriate surgical instruments are introduced through the bronchoscope. The physician then excises the tumor, ensuring that the procedure is performed with precision to minimize complications.

3. Post-Procedure

After the completion of the bronchoscopy and tumor excision, the patient is monitored for any immediate complications. Post-procedure care may include observation for respiratory distress, bleeding, or infection. Patients are typically advised to rest and may be given specific instructions regarding activity levels, diet, and follow-up appointments. The healthcare provider will also discuss any potential symptoms to watch for and when to seek further medical attention. Recovery time may vary depending on the extent of the procedure and the patient's overall health.

Short Descr BRONCHOSCOPY W/TUMOR EXCISE
Medium Descr BRONCHOSCOPY W/EXCISION TUMOR
Long Descr Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special payment adjustment rules for multiple endoscopic procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 31622  Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8F - Endoscopy - bronchoscopy
MUE 1
CCS Clinical Classification 42 - Other OR therapeutic procedures on respiratory system

This is a primary code that can be used with these additional add-on codes.

31627 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code 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])
31654 Addon Code MPFS Status: Active Code APC N ASC N1 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure[s])
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GC This service has been performed in part by a resident under the direction of a teaching physician
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2010-01-01 Changed Code description changed.
2004-01-01 Changed Code description changed.
2001-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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