Let us begin with the premise that endobronchial ultrasound (EBUS) is the single most useful pulmonary procedure introduced in decades and should be available to all patients with thoracic adenopathy requiring evaluation. The question then becomes when and where rather than whether it should be offered. In this issue of CHEST (see page 506), Pastis and colleagues1 report an encouraging analysis showing positive downstream revenue resulting from their introduction of EBUS to their institution. The authors are based at an academic institution, but their results may be extrapolated to other settings. The authors do present the ideal: a quick, safe, efficient, and cost-effective procedure that benefits patients while financially benefiting the institution. It will be telling whether this encouraging information will be used to offer patients the best application of this outstanding technology.