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CPT code 32400: Pleural biopsy, percutaneous needle2026 Medicare rate & RVUs in Puerto Rico

Reports percutaneous needle sampling of pleural tissue when a clinician needs a tissue diagnosis from the lining around the lungs.

CMS RVU26DEffective Oct 1, 2026One payment locality998 Medicare services in 2024

In Puerto Rico, Medicare pays $167.38 for 32400 in the office and $72.49 when it’s performed in a hospital or facility.

$167.38Office (non-facility)
$72.49Hospital or facility
+0.6%vs the national office rate ($166.34)

Check a contract rate as a % of Medicare · 32400 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 32400 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 32400 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 32400 covers

A clinician passes a needle through the chest wall to obtain pleural tissue for diagnostic evaluation. Pulmonologists, interventional radiologists, and thoracic surgeons may perform the procedure, often in a hospital setting. The target is the pleura, not a lung nodule or mediastinal mass; aspiration of pleural fluid alone is a different service.

Report this code when the needle biopsy samples pleural tissue, and document the target, percutaneous approach, and reason tissue was needed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 32400

Across 109 of 109 payment localities, the office rate for 32400 runs from $148.92 in Arkansas to $215.34 in San Benito County, CA. Puerto Rico pays $167.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

32400 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$167.38
  2. Los Angeles, CA · California$185.50+$18.12
  3. Washington, DC area · District of Columbia$188.43+$21.05
  4. Miami, FL · Florida$179.75+$12.37
  5. Chicago, IL · Illinois$175.04+$7.66
  6. Manhattan, NY · New York$190.20+$22.82
  7. Alaska · Alaska$199.05+$31.67

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

32400 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$150.87$68.74
ArkansasArkansas$148.92$68.29
ArizonaArizona$162.28$71.33
Bakersfield, CACalifornia$174.95$72.09
Chico, CACalifornia$174.40$71.53
El Centro, CACalifornia$174.43$71.56
Fresno, CACalifornia$174.40$71.53
Hanford, CACalifornia$174.40$71.53

32400 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$148.92

$199.05

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
32400 office rate range by state
State / territoryOffice rate rangeLocalities
AK$199.051
AL$150.871
AR$148.921
AZ$162.281
CA$174.40–$215.3429
CO$172.291
CT$176.671
DC$188.431
DE$164.781
FL$164.83–$179.753
GA$156.38–$169.362
GU$177.901
HI$177.901
IA$153.971
ID$154.941
IL$160.77–$175.044
IN$155.741
KS$153.481
KY$154.411
LA$154.25–$161.082
MA$171.49–$187.992
MD$167.65–$188.433
ME$155.83–$163.192
MI$158.16–$166.862
MN$165.091
MO$151.98–$161.413
MS$150.471
MT$166.321
NC$157.271
ND$162.771
NE$154.681
NH$169.801
NJ$178.68–$186.822
NM$159.011
NV$165.441
NY$159.41–$194.615
OH$157.431
OK$153.991
OR$164.14–$177.142
PA$157.57–$172.752
PR$167.381
RI$170.171
SC$157.621
SD$162.341
TN$154.191
TX$156.65–$171.738
UT$159.551
VA$162.82–$188.432
VI$167.381
VT$162.341
WA$171.10–$191.462
WI$157.861
WV$155.451
WY$164.771

See 32400 in every payment locality

How the 32400 rate is calculated

Each of 32400’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 32400

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.72

1.72 RVUs× 1.000 GPCI

Practice expense3.08

3.08 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

4.9800

Conversion factor

$33.4009

Medicare rate

$166.34

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,710

Code
32400
Physician work
1.72
Practice expense
3.08
Malpractice
0.18

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 32400 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.72× 1.0001.7200
Practice expense3.08× 1.0113.1139
Malpractice0.18× 0.9850.1773
Total RVUs5.0112
Conversion factor× 33.4009

Office rate, Puerto Rico$167.38

Office: (1.72 × 1 + 3.08 × 1.011 + 0.18 × 0.985) × $33.4009 = $167.38

Facility: (1.72 × 1 + 0.27 × 1.011 + 0.18 × 0.985) × $33.4009 = $72.49

Open 32400 in the RVU calculator

Payment rules and modifiers for 32400

The CMS indicators that decide how 32400 is paid alongside other services.

CMS payment indicators · 32400

Pleural biopsy, percutaneous needle

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

32400 without 51 · national office

$166.34

Pleural biopsy, percutaneous needle

32400-51 · Second procedure: 50%

$83.17

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 32400

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 32400
CodeHow it relatesOffice range, Puerto Rico
Used instead
32408Core biopsy, lung or mediastinumPercutaneous core biopsy when the target is lung or mediastinal tissue rather than pleura.$811.71
32609Pleural biopsy, thoracoscopic approachPleural tissue biopsy performed through a diagnostic thoracoscopy.No office rate
32555Thoracentesis, with imaging guidanceImage-guided fluid aspiration may be selected when pleural fluid, rather than tissue, is the diagnostic target.$313.38

How 32400 has changed in Puerto Rico

32400 · Office / nonfacility

$167.38

Effective 2026-10-01

The base rate is $2.45 higher than on 2025-10-01, moving from $164.93 to $167.38 (1.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $164.93changed to$167.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.76 changed to 1.72
    • Practice expense RVU 3.15 changed to 3.08
    • Malpractice RVU 0.17 changed to 0.18
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $168.38changed to$164.93

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.10 changed to 3.15
    • Malpractice RVU 0.18 changed to 0.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $165.64changed to$168.38

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $171.19changed to$165.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.09 changed to 3.10
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $170.45changed to$171.19

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $173.10changed to$170.45

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.05 changed to 3.09
    • Malpractice RVU 0.17 changed to 0.18
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $168.22changed to$173.10

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.89 changed to 3.05
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $165.27changed to$168.22

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.65 changed to 2.89
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $159.50changed to$165.27

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.49 changed to 2.65
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $154.98changed to$159.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.37 changed to 2.49

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $139.97changed to$154.98

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.38 changed to 2.37
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $125.27changed to$139.97

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.40 changed to 2.38
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $125.94changed to$125.27

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.18 changed to 0.16

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $125.31changed to$125.94

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $123.20changed to$125.31

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.36 changed to 2.40
    • Malpractice RVU 0.17 changed to 0.18
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $119.77changed to$123.20

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.53 changed to 2.36
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $119.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$167.38$72.49RVU26D
2026-07-01$167.38$72.49RVU26C
2026-04-01$167.38$72.49RVU26B
2026-01-01$167.38$72.49RVU26A
2025-10-01$164.93$79.92RVU25D
2025-07-01$164.93$79.92RVU25C
2025-04-01$164.93$79.92RVU25B
2025-01-01$164.93$79.92RVU25A
2024-10-01$168.38$81.90RVU24D
2024-07-01$168.38$81.90RVU24C
2024-04-01$168.38$81.90RVU24B
2024-03-09$168.38$81.90RVU24AR
2024-01-01$165.64$80.56RVU24A
2023-10-01$171.19$84.09RVU23D
2023-07-01$170.45$84.04RVU23C
2023-04-01$170.45$84.04RVU23B
2023-01-01$170.45$84.04RVU23A
2022-10-01$173.10$85.89RVU22D
2022-07-01$173.10$85.89RVU22C
2022-04-01$173.10$85.89RVU22B
2022-01-01$173.10$85.89RVU22A
2021-10-01$168.22$85.92RVU21D
2021-07-01$168.22$85.92RVU21C
2021-04-01$168.22$85.92RVU21B
2021-01-01$168.22$85.92RVU21A
2020-10-01$165.27$89.60RVU20D
2020-07-01$165.27$89.60RVU20C
2020-04-01$165.27$89.60RVU20B
2020-01-01$165.27$89.60RVU20A
2019-10-01$159.50$90.19RVU19D
2019-07-01$159.50$90.19RVU19C
2019-04-01$159.50$90.19RVU19B
2019-01-01$159.50$90.19RVU19A
2018-10-01$154.98$90.45RVU18D
2018-07-01$154.98$90.45RVU18C
2018-04-01$154.98$90.45RVU18B
2018-01-01$154.98$90.45RVU18AR1
2017-10-01$139.97$85.28RVU17D
2017-07-01$139.97$85.28RVU17C
2017-04-01$139.97$85.28RVU17B
2017-01-01$139.97$85.28RVU17A
2016-10-01$125.27$79.84RVU16D
2016-07-01$125.27$79.84RVU16C
2016-04-01$125.27$79.84RVU16B
2016-01-01$125.27$79.84RVU16A
2015-10-01$125.94$80.34RVU15D
2015-07-01$125.94$80.34RVU15C
2015-04-01$125.31$79.94RVU15B
2015-01-01$125.31$79.94RVU15A
2014-10-01$123.20$79.57RVU14D
2014-07-01$123.20$79.57RVU14C
2014-04-01$123.20$79.57RVU14B
2014-01-01$123.20$79.57RVU14A
2013-10-01$119.77$75.48RVU13D
2013-07-01$119.77$75.48RVU13C
2013-04-01$119.77$75.48RVU13B
2013-01-01$119.77$75.48RVU13AR

Price 32400 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

32400 billing questions

How do I distinguish this from 32408?

Use 32400 for needle sampling of pleural tissue. Code 32408 describes percutaneous core biopsy of lung or mediastinal tissue.

Can I report this for pleural fluid removal?

No. This code is for tissue sampling. Thoracentesis codes describe pleural fluid aspiration.

Is modifier 50 appropriate for a biopsy on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant or co-surgeon be paid?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What documentation supports reporting the biopsy?

Document that the target was pleura, that tissue was obtained by a percutaneous needle approach, and the clinical reason for tissue sampling.

How does the multiple-procedure reduction affect payment?

For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 32400PPRRVU2026_Oct_nonQPP.csv, line 3,710 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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