FeeBase
Log inGet started
Menu

CPT code 32551: Chest tube, open thoracostomy2026 Medicare rate & RVUs

Report open tube thoracostomy when a chest tube is placed into the pleural space for ongoing drainage of air or fluid.

CMS RVU26DEffective Oct 1, 2026109 payment localities25.6K Medicare services in 2024

Medicare pays $142.96 for 32551 nationally in a facility.

Medicare rate · 32551

Chest tube, open thoracostomy

Office or facility?

Work RVUs
2.96
Total RVUs
4.28
Global days
000

National rate · 2026

$142.96

Facility setting, before claim adjustments.

See every locality for 32551 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 32551 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 32551 covers

This service places a chest tube into the pleural space through an open approach and connects it to a drainage system. It is commonly performed for pneumothorax, hemothorax, or a pleural collection requiring continued drainage. Emergency physicians, trauma or thoracic surgeons, pulmonologists, and critical care clinicians may perform it, most often in a hospital or emergency setting.

Report 32551 for the open tube placement, not for a percutaneous pleural catheter or a one-time fluid aspiration. Documentation should identify the indication, side, approach, tube placement, and connection to drainage. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral procedures, modifier 50 is paid at 150%. In a session with multiple procedures, the highest-valued procedure is paid in full and the others at 50%. CMS does not pay an assistant at surgery for this service and does not permit co-surgeon or team-surgery reporting.

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 32551 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

32551 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$131.77
AlaskaUnavailable$185.81
ArizonaUnavailable$139.51
ArkansasUnavailable$130.42
Atlanta, GAUnavailable$147.36
Austin, TXUnavailable$142.55
Bakersfield, CAUnavailable$140.12
Baltimore area, MDUnavailable$150.77
Beaumont, TXUnavailable$139.34
Brazoria, TXUnavailable$139.47

32551 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.

View every state and territory as a table
32551 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 32551 rate is calculated

Each of 32551’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 · 32551

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.96

2.96 RVUs× 1.000 GPCI

Practice expense0.77

0.77 RVUs× 1.000 GPCI

Malpractice0.55

0.55 RVUs× 1.000 GPCI

Adjusted RVUs

4.2800

Conversion factor

$33.4009

Medicare rate

$142.96

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

Payment rules and modifiers for 32551

The CMS indicators that decide how 32551 is paid alongside other services.

CMS payment indicators · 32551

Chest tube, open thoracostomy

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

32551 without 50 · national facility

$142.96

Chest tube, open thoracostomy

32551-50 · Bilateral: 150%

$214.44

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

32551 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 32551

    Chest tube, open thoracostomy2.96 wRVU

    Not priced

  • 32550

    Pleural catheter, tunneled catheter with cuff3.82 wRVU

    $783.59

  • 32556

    Pleural catheter, without imaging guidance2.44 wRVU

    $841.03

  • 32557

    Pleural catheter, with imaging guidance3.04 wRVU

    $647.98

  • 32555

    Thoracentesis, with imaging guidance2.21 wRVU

    $310.96

How to choose

32550Pleural catheterTunneled catheter with cuff
32550 is for placement of a tunneled indwelling pleural catheter. Use 32551 for open tube thoracostomy instead.
32556Pleural catheterWithout imaging guidance
32556 describes percutaneous pleural catheter placement without imaging guidance; 32551 is for an open chest tube approach.
32557Pleural catheterWith imaging guidance
32557 describes percutaneous pleural catheter placement with imaging guidance. It is not the open tube thoracostomy reported with 32551.
32555ThoracentesisWith imaging guidance
32555 is image-guided aspiration of pleural fluid, generally for drainage without placement of a chest tube for continued drainage.

Codes related to 32551

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

Codes related to 32551
CodeHow it relatesNational office range
Used instead
32550Pleural catheter, tunneled catheter with cuffA tunneled indwelling pleural catheter may be selected for ongoing drainage in a different clinical situation.$685.23–$1,072.14
32556Pleural catheter, without imaging guidancePercutaneous pleural catheter placement without imaging, rather than open tube thoracostomy.$729.69–$1,174.52
32557Pleural catheter, with imaging guidancePercutaneous pleural catheter placement with imaging guidance, rather than open tube thoracostomy.$567.14–$890.69
32554Thoracentesis, without imaging guidancePleural fluid aspiration without imaging may be selected when one-time drainage is appropriate.$229.72–$349.70
32555Thoracentesis, with imaging guidancePleural fluid aspiration with imaging may be selected when one-time drainage is appropriate.$275.00–$417.24

32551 billing questions

When is 32551 appropriate?

Use it for open tube thoracostomy to provide ongoing pleural drainage, such as for a pneumothorax, hemothorax, or pleural collection. The record should support the clinical need for tube drainage.

How does 32551 differ from 32556 or 32557?

32551 describes open tube thoracostomy. Codes 32556 and 32557 describe percutaneous pleural catheter placement, without and with imaging guidance, respectively.

Should modifier 50 be used when tubes are placed on both sides?

For a bilateral procedure, report modifier 50. CMS pays the bilateral service at 150%.

Is same-day care separately payable with 32551?

No. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

How does the multiple-procedure reduction affect 32551?

When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the other procedures at 50%.

Can an assistant or co-surgeon be reported for 32551?

CMS does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting are not permitted.

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 32551PPRRVU2026_Oct_nonQPP.csv, line 3,730 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 32551 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 32551 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet