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CPT code 32554: Thoracentesis, without imaging guidance2026 Medicare rate & RVUs in King County, WA

Report 32554 for diagnostic sampling or therapeutic drainage of pleural fluid by needle aspiration performed without imaging guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality9.7K Medicare services in 2024

In King County, WA, Medicare pays $306.33 for 32554 in the office and $83.79 when it’s performed in a hospital or facility.

$306.33Office (non-facility)
$83.79Hospital or facility
+17.6%vs the national office rate ($260.53)

Check a contract rate as a % of Medicare · 32554 nationwide

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

We’ll open 32554 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 32554 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How King County, WA compares for 32554

Across 109 of 109 payment localities, the office rate for 32554 runs from $229.72 in Arkansas to $349.70 in San Benito County, CA. King County, WA pays $306.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

32554 in King County, WA vs other payment areas
  1. King County, WA · this page$306.33
  2. Rest of Washington · Washington$269.92−$36.41
  3. Los Angeles, CA · California$296.17−$10.16
  4. Washington, DC area · District of Columbia$299.11−$7.22
  5. Miami, FL · Florida$279.22−$27.11
  6. Chicago, IL · Illinois$271.00−$35.33
  7. Manhattan, NY · New York$299.91−$6.42

Other areas in Washington first, then benchmark localities. Bars start at $0.

Every other payment area

32554 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$299.57$106.42
AlabamaAlabama$233.18$74.49
ArkansasArkansas$229.72$73.92
ArizonaArizona$253.49$77.75
Bakersfield, CACalifornia$277.57$78.79
Chico, CACalifornia$276.94$78.16
El Centro, CACalifornia$276.97$78.20
Fresno, CACalifornia$276.94$78.16

32554 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.

$229.72

$313.32

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
32554 office rate range by state
State / territoryOffice rate rangeLocalities
AK$299.571
AL$233.181
AR$229.721
AZ$253.491
CA$276.94–$349.7029
CO$272.141
CT$278.151
DC$299.111
DE$257.781
FL$255.50–$279.223
GA$240.88–$265.222
GU$284.211
HI$284.211
IA$239.771
ID$241.281
IL$247.56–$271.604
IN$242.731
KS$238.391
KY$238.351
LA$237.88–$250.012
MA$270.35–$299.892
MD$262.88–$299.113
ME$242.32–$256.192
MI$244.52–$258.532
MN$261.231
MO$233.52–$251.213
MS$231.681
MT$260.511
NC$244.971
ND$256.361
NE$241.201
NH$267.621
NJ$281.46–$295.832
NM$245.801
NV$259.551
NY$248.72–$307.065
OH$243.671
OK$238.161
OR$257.67–$281.252
PA$244.20–$270.922
PR$262.561
RI$267.311
SC$244.701
SD$255.871
TN$239.591
TX$242.53–$271.128
UT$248.151
VA$255.16–$299.112
VI$262.561
VT$255.121
WA$269.92–$306.332
WI$247.511
WV$238.081
WY$258.701

See 32554 in every payment locality

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

Office or facility?

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.

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,733

Code
32554
Physician work
1.77
Practice expense
5.82
Malpractice
0.21

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 32554 in King County, WA
ComponentRVULocality factorAdjusted
Physician work1.77× 1.0501.8585
Practice expense5.82× 1.2277.1411
Malpractice0.21× 0.8170.1716
Total RVUs9.1712
Conversion factor× 33.4009

Office rate, King County, WA$306.33

Office: (1.77 × 1.05 + 5.82 × 1.227 + 0.21 × 0.817) × $33.4009 = $306.33

Facility: (1.77 × 1.05 + 0.39 × 1.227 + 0.21 × 0.817) × $33.4009 = $83.79

Open 32554 in the RVU calculator

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

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

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).

When to use modifier 50

Codes related to 32554

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

Codes related to 32554
CodeHow it relatesOffice range, King County, WA
Used instead
32555Thoracentesis, with imaging guidancePleural fluid aspiration performed with imaging guidance.$365.47
32556Pleural catheter, without imaging guidancePleural catheter insertion without imaging for drainage rather than one-time aspiration.$1,012.46
32557Pleural catheter, with imaging guidancePleural catheter insertion with imaging for ongoing drainage.$772.58
32551Chest tube, open thoracostomyChest tube insertion for pleural drainage rather than needle aspiration.No office rate

How 32554 has changed in King County, WA

32554 · Office / nonfacility

$306.33

Effective 2026-10-01

The base rate is $48.13 higher than on 2025-10-01, moving from $258.20 to $306.33 (18.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $258.20changed to$306.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.82 changed to 1.77
    • Practice expense RVU 4.84 changed to 5.82
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $271.39changed to$258.20

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.98 changed to 4.84

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $266.96changed to$271.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $274.52changed to$266.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.01 changed to 4.98
    • Malpractice RVU 0.20 changed to 0.21
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $285.07changed to$274.52

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.19 changed to 5.01
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $282.16changed to$285.07

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.07 changed to 5.19
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $255.99changed to$282.16

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.32 changed to 5.07
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $238.94changed to$255.99

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.00 changed to 4.32
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $229.19changed to$238.94

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.77 changed to 4.00

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $225.96changed to$229.19

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.73 changed to 3.77
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $222.99changed to$225.96

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.70 changed to 3.73
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $223.98changed to$222.99

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $222.86changed to$223.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $220.31changed to$222.86

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.63 changed to 3.70
    • Malpractice RVU 0.16 changed to 0.19
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $639.17changed to$220.31

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.66 changed to 3.63
    • Malpractice RVU 0.17 changed to 0.16
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $639.17

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$306.33$83.79RVU26D
2026-07-01$306.33$83.79RVU26C
2026-04-01$306.33$83.79RVU26B
2026-01-01$306.33$83.79RVU26A
2025-10-01$258.20$90.08RVU25D
2025-07-01$258.20$90.08RVU25C
2025-04-01$258.20$90.08RVU25B
2025-01-01$258.20$90.08RVU25A
2024-10-01$271.39$92.71RVU24D
2024-07-01$271.39$92.71RVU24C
2024-04-01$271.39$92.71RVU24B
2024-03-09$271.39$92.71RVU24AR
2024-01-01$266.96$91.19RVU24A
2023-10-01$274.52$93.33RVU23D
2023-07-01$274.52$93.33RVU23C
2023-04-01$274.52$93.33RVU23B
2023-01-01$274.52$93.33RVU23A
2022-10-01$285.07$95.41RVU22D
2022-07-01$285.07$95.41RVU22C
2022-04-01$285.07$95.41RVU22B
2022-01-01$285.07$95.41RVU22A
2021-10-01$282.16$95.93RVU21D
2021-07-01$282.16$95.93RVU21C
2021-04-01$282.16$95.93RVU21B
2021-01-01$282.16$95.93RVU21A
2020-10-01$255.99$98.07RVU20D
2020-07-01$255.99$98.07RVU20C
2020-04-01$255.99$98.07RVU20B
2020-01-01$255.99$98.07RVU20A
2019-10-01$238.94$97.28RVU19D
2019-07-01$238.94$97.28RVU19C
2019-04-01$238.94$97.28RVU19B
2019-01-01$238.94$97.28RVU19A
2018-10-01$229.19$97.58RVU18D
2018-07-01$229.19$97.58RVU18C
2018-04-01$229.19$97.58RVU18B
2018-01-01$229.19$97.58RVU18AR1
2017-10-01$225.96$95.84RVU17D
2017-07-01$225.96$95.84RVU17C
2017-04-01$225.96$95.84RVU17B
2017-01-01$225.96$95.84RVU17A
2016-10-01$222.99$94.38RVU16D
2016-07-01$222.99$94.38RVU16C
2016-04-01$222.99$94.38RVU16B
2016-01-01$222.99$94.38RVU16A
2015-10-01$223.98$94.07RVU15D
2015-07-01$223.98$94.07RVU15C
2015-04-01$222.86$93.60RVU15B
2015-01-01$222.86$93.60RVU15A
2014-10-01$220.31$96.31RVU14D
2014-07-01$220.31$96.31RVU14C
2014-04-01$220.31$96.31RVU14B
2014-01-01$220.31$96.31RVU14A
2013-10-01$639.17$93.87RVU13D
2013-07-01$639.17$93.87RVU13C
2013-04-01$639.17$93.87RVU13B
2013-01-01$639.17$93.87RVU13AR

Price 32554 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 32554 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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

Show the CMS file lines behind this rate
RVUs for 32554PPRRVU2026_Oct_nonQPP.csv, line 3,733 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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