CPT code 32551: Chest tube, open thoracostomy2026 Medicare rate & RVUs in California
Report open tube thoracostomy when a chest tube is placed into the pleural space for ongoing drainage of air or fluid.
CMS doesn’t publish an office rate for 32551 in California.
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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On this page 9 sections
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 in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $140.12 |
| Chico, CA | Unavailable | $138.58 |
| El Centro, CA | Unavailable | $138.67 |
| Fresno, CA | Unavailable | $138.58 |
| Hanford, CA | Unavailable | $138.58 |
| Los Angeles, CA | Unavailable | $145.54 |
| Madera, CA | Unavailable | $138.58 |
| Marin County, CA | Unavailable | $152.95 |
| Merced, CA | Unavailable | $138.58 |
| Modesto, CA | Unavailable | $138.58 |
| Napa, CA | Unavailable | $148.32 |
| Oxnard, CA | Unavailable | $143.48 |
| Redding, CA | Unavailable | $138.58 |
| Rest of California | Unavailable | $138.58 |
| Riverside, CA | Unavailable | $144.50 |
| Sacramento, CA | Unavailable | $142.18 |
| Salinas, CA | Unavailable | $141.59 |
| San Benito County, CA | Unavailable | $156.67 |
| San Diego, CA | Unavailable | $142.55 |
| San Francisco, CA | Unavailable | $152.33 |
| San Luis Obispo, CA | Unavailable | $139.69 |
| Santa Clara County, CA | Unavailable | $154.12 |
| Santa Cruz, CA | Unavailable | $142.04 |
| Santa Maria, CA | Unavailable | $141.47 |
| Santa Rosa, CA | Unavailable | $143.26 |
| Stockton, CA | Unavailable | $138.58 |
| Vallejo, CA | Unavailable | $147.42 |
| Visalia, CA | Unavailable | $138.58 |
| Yuba City, CA | Unavailable | $138.58 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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).
32551 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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