CPT code 32554: Thoracentesis, without imaging guidance2026 Medicare rate & RVUs in Missouri
Report 32554 for diagnostic sampling or therapeutic drainage of pleural fluid by needle aspiration performed without imaging guidance.
Medicare pays $233.52–$251.21 for 32554 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
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 32554 covers
Code 32554 covers needle aspiration of pleural fluid without imaging guidance, either to obtain a diagnostic sample or relieve a symptomatic effusion. A pulmonologist, hospitalist, or other qualified physician may perform the procedure at bedside, in an office, or in a facility. The defining distinction is a one-time needle aspiration rather than placement of a catheter for ongoing drainage; aspiration performed with imaging guidance is reported with 32555.
Document the indication, side, that aspiration was performed without imaging guidance, and whether fluid was collected or drained. The 0-day global period includes same-day preoperative and postoperative care. For bilateral performance, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is barred; 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.
Where 32554 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$233.52 to $251.21
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $248.51 | $78.20 |
| Metropolitan St. Louis, MO | $251.21 | $78.55 |
| Rest of Missouri | $233.52 | $77.18 |
How the 32554 rate is calculated
Each of 32554’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 · 32554
RVUs × geographic indexes × conversion factor
Work1.77
1.77 RVUs× 1.000 GPCI
Practice expense5.82
5.82 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
7.8000
Conversion factor
$33.4009
Medicare rate
$260.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32554
The CMS indicators that decide how 32554 is paid alongside other services.
CMS payment indicators · 32554
Thoracentesis, without imaging guidance
| 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
32554 without 50 · national office
$260.53
Thoracentesis, without imaging guidance
32554-50 · Bilateral: 150%
$390.79
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).
32554 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 32555ThoracentesisWith imaging guidance
- Choose 32555 when imaging guidance is used for pleural fluid aspiration; 32554 describes aspiration without imaging guidance.
- 32556Pleural catheterWithout imaging guidance
- 32556 describes insertion of a pleural drainage catheter without imaging. 32554 is for needle aspiration without catheter placement.
- 32557Pleural catheterWith imaging guidance
- 32557 describes imaging-guided placement of a pleural drainage catheter, while 32554 is aspiration without imaging guidance or catheter placement.
- 32551Chest tubeOpen thoracostomy
- 32551 is for insertion of a chest tube; 32554 is for needle aspiration of pleural fluid.
32554 billing questions
When should 32555 be used instead?
Use 32555 when pleural fluid aspiration is performed with imaging guidance. Code 32554 is for aspiration without imaging guidance.
Does 32554 include placement of a pleural catheter?
No. This code describes needle aspiration, not leaving a catheter in the pleural space for ongoing drainage. Catheter insertion is reported with the applicable catheter code.
How is bilateral aspiration reported?
Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.
What should the procedure note document?
Record the indication, side treated, that the aspiration was performed without imaging guidance, and whether fluid was sampled or drained.
Are same-day preoperative and postoperative services included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
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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