CPT code 32555: Thoracentesis, with imaging guidance2026 Medicare rate & RVUs in California
Reports needle or catheter aspiration of pleural fluid with imaging guidance, typically to investigate or relieve a pleural effusion.
Medicare pays $330.87–$417.24 for 32555 in the office in California, from Chico, CA to San Benito County, CA. 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 32555 covers
A clinician uses a needle or catheter to remove fluid from the pleural space, with imaging guidance during the procedure. Thoracentesis may be performed to obtain fluid for diagnostic testing or to relieve symptoms from an effusion. Pulmonologists, interventional radiologists, and other clinicians who perform pleural procedures commonly provide it in hospital or outpatient settings.
Report this code when imaging guidance is used for the aspiration; the record should support the pleural-fluid indication, side treated, procedure performed, and use of imaging. The same-day preoperative and postoperative care is included in its 0-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code, and 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 32555 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 payment localities
$330.87 to $417.24
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $331.55 | $93.60 |
| Chico, CA | $330.87 | $92.92 |
| El Centro, CA | $330.91 | $92.96 |
| Fresno, CA | $330.87 | $92.92 |
| Hanford, CA | $330.87 | $92.92 |
| Los Angeles, CA | $353.57 | $96.74 |
| Madera, CA | $330.87 | $92.92 |
| Marin County, CA | $408.22 | $102.10 |
| Merced, CA | $330.87 | $92.92 |
| Modesto, CA | $330.87 | $92.92 |
| Napa, CA | $385.07 | $98.93 |
| Oxnard, CA | $352.08 | $95.46 |
| Redding, CA | $330.87 | $92.92 |
| Rest of California | $330.87 | $92.92 |
| Riverside, CA | $333.27 | $95.32 |
| Sacramento, CA | $347.67 | $95.17 |
| Salinas, CA | $346.38 | $94.75 |
| San Benito County, CA | $417.24 | $104.18 |
| San Diego, CA | $354.85 | $95.19 |
| San Francisco, CA | $407.97 | $101.85 |
| San Luis Obispo, CA | $340.75 | $93.47 |
| Santa Clara County, CA | $416.22 | $103.16 |
| Santa Cruz, CA | $358.51 | $94.73 |
| Santa Maria, CA | $347.77 | $94.62 |
| Santa Rosa, CA | $362.16 | $95.56 |
| Stockton, CA | $330.87 | $92.92 |
| Vallejo, CA | $384.71 | $98.57 |
| Visalia, CA | $330.87 | $92.92 |
| Yuba City, CA | $330.87 | $92.92 |
How the 32555 rate is calculated
Each of 32555’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 · 32555
RVUs × geographic indexes × conversion factor
Work2.21
2.21 RVUs× 1.000 GPCI
Practice expense6.88
6.88 RVUs× 1.000 GPCI
Malpractice0.22
0.22 RVUs× 1.000 GPCI
Adjusted RVUs
9.3100
Conversion factor
$33.4009
Medicare rate
$310.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32555
The CMS indicators that decide how 32555 is paid alongside other services.
CMS payment indicators · 32555
Thoracentesis, with 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
32555 without 50 · national office
$310.96
Thoracentesis, with imaging guidance
32555-50 · Bilateral: 150%
$466.44
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).
32555 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 32554ThoracentesisWithout imaging guidance
- Choose 32554 for pleural-fluid aspiration without imaging guidance; 32555 is for aspiration performed with imaging guidance.
- 32556Pleural catheterWithout imaging guidance
- 32556 covers pleural catheter placement without imaging for drainage. 32555 is fluid aspiration with imaging, not catheter placement for ongoing drainage.
- 32557Pleural catheterWith imaging guidance
- 32557 covers pleural catheter placement with imaging for drainage; 32555 covers aspiration of pleural fluid with imaging guidance.
32555 billing questions
When should 32555 be chosen over 32554?
Use 32555 when imaging guidance is used during pleural-fluid aspiration. Code 32554 describes aspiration without imaging guidance.
Can imaging guidance be billed separately?
Imaging guidance is part of 32555. Do not report separate imaging guidance for that same aspiration.
How is bilateral thoracentesis reported?
For bilateral treatment, report the procedure with modifier 50; CMS pays it at 150%.
What documentation supports 32555?
Document the indication for aspiration, the side treated, the fluid-removal procedure, and that imaging guidance was used.
Does 32555 describe ongoing pleural drainage?
No. It describes aspiration of pleural fluid. Catheter-placement codes such as 32556 or 32557 apply when a catheter is inserted for drainage.
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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