CPT code 32486: Sleeve lobectomy, lobe resection with airway reconstruction2026 Medicare rate & RVUs in Texas
Reports lung resection combining lobectomy with bronchial sleeve reconstruction, typically for a central airway lesion when preserving the remaining lung is feasible.
CMS doesn’t publish an office rate for 32486 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $2,163.47 |
| Beaumont, TX | Unavailable | $2,112.60 |
| Brazoria, TX | Unavailable | $2,105.87 |
| Dallas, TX | Unavailable | $2,136.89 |
| Fort Worth, TX | Unavailable | $2,137.20 |
| Galveston, TX | Unavailable | $2,123.64 |
| Houston, TX | Unavailable | $2,316.74 |
| Rest of Texas | Unavailable | $2,120.10 |
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.
How the rate is built · 32486
RVUs × geographic indexes × conversion factor
Work41.81
41.81 RVUs× 1.000 GPCI
Practice expense12.79
12.79 RVUs× 1.000 GPCI
Malpractice10.55
10.55 RVUs× 1.000 GPCI
Adjusted RVUs
65.1500
Conversion factor
$33.4009
Medicare rate
$2,176.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32486
32486 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32486
Sleeve lobectomy, lobe resection with airway reconstruction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 32486
Sleeve lobectomy, lobe resection with airway reconstruction
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
32486 without 51 · national facility
$2,176.07
Sleeve lobectomy, lobe resection with airway reconstruction
32486-51 · Second procedure: 50%
$1,088.04
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%).
32486 compared with similar codes
Compare codes · National
5 codes, side by side
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.
32486 billing questions
When should 32486 be chosen instead of a conventional lobectomy code?
Choose 32486 when the operation includes resection of the involved bronchus and reconstruction of the airway along with removal of a lung lobe. A lobectomy without that bronchial sleeve work is not this service.
Is bronchial reconstruction separately reported with 32486?
The bronchial sleeve resection and reconstruction are part of the combined service represented by 32486. Do not treat that reconstruction as a separate service from the sleeve lobectomy.
How does 32486 differ from sleeve pneumonectomy 32442?
A sleeve lobectomy removes a lobe and reconstructs the airway while preserving the remaining lung. Sleeve pneumonectomy involves removal of the entire lung with airway reconstruction.
Can modifier 50 be used for a sleeve lobectomy?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
What documentation supports reporting 32486?
The operative report should show the lobe removed, the bronchial portion resected, and the airway reconstruction. It should distinguish the operation from a lobectomy without bronchial sleeve work.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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
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