CPT code 32486: Sleeve lobectomy, lobe resection with airway reconstruction2026 Medicare rate & RVUs

Medicare pays $2,176.07 for 32486 nationally in a facility.

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

What 32486 covers

A sleeve lobectomy removes an affected lung lobe together with the involved portion of bronchus, then reconnects the airway to preserve the remaining lung. Thoracic surgeons most often perform it in an operating room for a central lung lesion involving a lobar bronchus when resection with airway reconstruction is appropriate. The operation combines the lung resection and bronchial reconstruction in one service; it is distinct from removing an entire lung.

Report 32486 when the operative record supports both lobectomy and bronchial sleeve resection with airway reconstruction, rather than a conventional lobectomy alone. Documentation should identify the lobe removed, the bronchial resection and reconstruction, and the operative findings supporting the approach. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.

Where 32486 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

32486 rates by state

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

How the 32486 rate is calculated

Each of 32486’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.

Payment rules and modifiers for 32486

32486 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

32486 compared with similar codes

How to choose

32480Lung resectionSingle-lobe lobectomy

Use 32486 when the operation includes bronchial sleeve resection and airway reconstruction with the lobectomy. A lobectomy without that reconstruction is represented by 32480.

32482BilobectomyTwo right lung lobes

32482 represents removal of two lobes. 32486 represents a lobectomy with bronchial sleeve resection and reconstruction, not a bilobectomy.

32442PneumonectomySleeve airway resection

32442 is a sleeve pneumonectomy, involving removal of the entire lung. 32486 preserves the remaining lung after removal of the affected lobe and airway reconstruction.

32440PneumonectomyEntire lung removed

32440 represents removal of an entire lung without the sleeve-pneumonectomy distinction. Choose 32486 for lobectomy with bronchial sleeve reconstruction and lung preservation.

Codes related to 32486

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

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

Open CMS sourceHow we calculate rates