FeeBase
Log inGet started
Menu

CPT code 32556: Pleural catheter, without imaging guidance2026 Medicare rate & RVUs in Puerto Rico

Percutaneous placement of an indwelling pleural drainage catheter without imaging guidance when ongoing drainage is needed rather than a single aspiration.

CMS RVU26DEffective Oct 1, 2026One payment locality5K Medicare services in 2024

In Puerto Rico, Medicare pays $849.07 for 32556 in the office and $111.91 when it’s performed in a hospital or facility.

$849.07Office (non-facility)
$111.91Hospital or facility
+1.0%vs the national office rate ($841.03)

Check a contract rate as a % of Medicare · 32556 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 32556 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 32556 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 32556 covers

This service places a catheter percutaneously into the pleural space and leaves it in place for drainage, without imaging guidance. It is used to drain pleural fluid or air when a catheter is needed rather than a one-time needle aspiration. Pulmonologists, thoracic surgeons, and other physicians who manage pleural disease may perform it at the bedside or in a procedure setting. The method and documentation should support that the catheter was inserted into the pleural space and that imaging guidance was not used.

Report 32556 for the catheter placement, not for a thoracentesis that removes fluid without leaving a catheter. Document the indication, side, catheter placement, and whether imaging guidance was used; imaging-guided placement is represented by 32557. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery payment 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 Puerto Rico compares for 32556

Across 109 of 109 payment localities, the office rate for 32556 runs from $729.69 in Arkansas to $1,174.52 in San Benito County, CA. Puerto Rico pays $849.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

32556 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$849.07
  2. Los Angeles, CA · California$976.96+$127.89
  3. Washington, DC area · District of Columbia$979.83+$130.76
  4. Miami, FL · Florida$890.56+$41.49
  5. Chicago, IL · Illinois$861.35+$12.28
  6. Manhattan, NY · New York$974.54+$125.47
  7. Alaska · Alaska$924.80+$75.73

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

Every other payment area

32556 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$742.27$104.27
ArkansasArkansas$729.69$103.36
ArizonaArizona$816.09$109.55
Bakersfield, CACalifornia$909.48$110.34
Chico, CACalifornia$908.41$109.28
El Centro, CACalifornia$908.48$109.34
Fresno, CACalifornia$908.41$109.28
Hanford, CACalifornia$908.41$109.28

32556 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.

$729.69

$1,041.47

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

View every state and territory as a table
32556 office rate range by state
State / territoryOffice rate rangeLocalities
AK$924.801
AL$742.271
AR$729.691
AZ$816.091
CA$908.41–$1,174.5229
CO$887.131
CT$902.791
DC$979.831
DE$831.231
FL$814.38–$890.563
GA$762.71–$855.722
GU$938.201
HI$938.201
IA$770.071
ID$774.751
IL$782.99–$871.324
IN$780.141
KS$763.181
KY$757.051
LA$754.59–$798.632
MA$879.43–$987.972
MD$849.80–$979.833
ME$776.59–$829.752
MI$777.62–$823.362
MN$854.001
MO$737.60–$805.193
MS$733.951
MT$841.011
NC$786.511
ND$833.691
NE$775.821
NH$870.121
NJ$914.23–$966.562
NM$781.501
NV$839.721
NY$800.01–$998.065
OH$776.131
OK$758.331
OR$834.38–$922.112
PA$779.09–$875.522
PR$849.071
RI$865.911
SC$782.401
SD$832.831
TN$767.321
TX$772.91–$883.138
UT$794.941
VA$824.70–$979.832
VI$849.071
VT$827.461
WA$878.74–$1,012.462
WI$801.101
WV$748.481
WY$837.821

See 32556 in every payment locality

How the 32556 rate is calculated

Each of 32556’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 · 32556

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.44

2.44 RVUs× 1.000 GPCI

Practice expense22.37

22.37 RVUs× 1.000 GPCI

Malpractice0.37

0.37 RVUs× 1.000 GPCI

Adjusted RVUs

25.1800

Conversion factor

$33.4009

Medicare rate

$841.03

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,735

Code
32556
Physician work
2.44
Practice expense
22.37
Malpractice
0.37

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 32556 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.44× 1.0002.4400
Practice expense22.37× 1.01122.6161
Malpractice0.37× 0.9850.3644
Total RVUs25.4205
Conversion factor× 33.4009

Office rate, Puerto Rico$849.07

Office: (2.44 × 1 + 22.37 × 1.011 + 0.37 × 0.985) × $33.4009 = $849.07

Facility: (2.44 × 1 + 0.54 × 1.011 + 0.37 × 0.985) × $33.4009 = $111.91

Open 32556 in the RVU calculator

Payment rules and modifiers for 32556

The CMS indicators that decide how 32556 is paid alongside other services.

CMS payment indicators · 32556

Pleural catheter, 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

32556 without 50 · national office

$841.03

Pleural catheter, without imaging guidance

32556-50 · Bilateral: 150%

$1,261.55

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 32556

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

Codes related to 32556
CodeHow it relatesOffice range, Puerto Rico
Same family
32557Pleural catheter, with imaging guidancePleural catheter placement when imaging guidance is used.$653.70
Used instead
32554Thoracentesis, without imaging guidancePleural aspiration without imaging, without placement of an indwelling catheter.$262.56
32555Thoracentesis, with imaging guidancePleural aspiration with imaging, without placement of an indwelling catheter.$313.38
32550Pleural catheter, tunneled catheter with cuffPlacement of a tunneled pleural catheter for a different drainage approach.$790.36
32551Chest tube, open thoracostomyChest tube thoracostomy rather than percutaneous indwelling catheter placement.No office rate

How 32556 has changed in Puerto Rico

32556 · Office / nonfacility

$849.07

Effective 2026-10-01

The base rate is $153.86 higher than on 2025-10-01, moving from $695.21 to $849.07 (22.1%).

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

    $695.21changed to$849.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.50 changed to 2.44
    • Practice expense RVU 18.49 changed to 22.37
    • Malpractice RVU 0.38 changed to 0.37
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $739.91changed to$695.21

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 19.23 changed to 18.49
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $727.84changed to$739.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $761.79changed to$727.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 19.48 changed to 19.23
    • Malpractice RVU 0.35 changed to 0.37
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $756.70changed to$761.79

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $801.72changed to$756.70

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 20.19 changed to 19.48
    • Malpractice RVU 0.32 changed to 0.35
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $776.73changed to$801.72

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 19.31 changed to 20.19
    • Malpractice RVU 0.30 changed to 0.32

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $692.08changed to$776.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 16.27 changed to 19.31
    • Malpractice RVU 0.28 changed to 0.30
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $631.03changed to$692.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.63 changed to 16.27
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $575.61changed to$631.03

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.13 changed to 14.63
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $493.39changed to$575.61

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.93 changed to 13.13
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $410.84changed to$493.39

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.63 changed to 12.93
    • Malpractice RVU 0.24 changed to 0.28
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $421.61changed to$410.84

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.98 changed to 12.63
    • Malpractice RVU 0.28 changed to 0.24

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $419.51changed to$421.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $399.03changed to$419.51

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.39 changed to 12.98
    • Malpractice RVU 0.24 changed to 0.28
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $428.58changed to$399.03

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.80 changed to 12.39
    • Malpractice RVU 0.25 changed to 0.24
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $428.58

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$849.07$111.91RVU26D
2026-07-01$849.07$111.91RVU26C
2026-04-01$849.07$111.91RVU26B
2026-01-01$849.07$111.91RVU26A
2025-10-01$695.21$119.32RVU25D
2025-07-01$695.21$119.32RVU25C
2025-04-01$695.21$119.32RVU25B
2025-01-01$695.21$119.32RVU25A
2024-10-01$739.91$121.79RVU24D
2024-07-01$739.91$121.79RVU24C
2024-04-01$739.91$121.79RVU24B
2024-03-09$739.91$121.79RVU24AR
2024-01-01$727.84$119.81RVU24A
2023-10-01$761.79$123.72RVU23D
2023-07-01$756.70$123.69RVU23C
2023-04-01$756.70$123.69RVU23B
2023-01-01$756.70$123.69RVU23A
2022-10-01$801.72$125.69RVU22D
2022-07-01$801.72$125.69RVU22C
2022-04-01$801.72$125.69RVU22B
2022-01-01$801.72$125.69RVU22A
2021-10-01$776.73$125.69RVU21D
2021-07-01$776.73$125.69RVU21C
2021-04-01$776.73$125.69RVU21B
2021-01-01$776.73$125.69RVU21A
2020-10-01$692.08$128.58RVU20D
2020-07-01$692.08$128.58RVU20C
2020-04-01$692.08$128.58RVU20B
2020-01-01$692.08$128.58RVU20A
2019-10-01$631.03$128.03RVU19D
2019-07-01$631.03$128.03RVU19C
2019-04-01$631.03$128.03RVU19B
2019-01-01$631.03$128.03RVU19A
2018-10-01$575.61$127.54RVU18D
2018-07-01$575.61$127.54RVU18C
2018-04-01$575.61$127.54RVU18B
2018-01-01$575.61$127.54RVU18AR1
2017-10-01$493.39$120.14RVU17D
2017-07-01$493.39$120.14RVU17C
2017-04-01$493.39$120.14RVU17B
2017-01-01$493.39$120.14RVU17A
2016-10-01$410.84$112.98RVU16D
2016-07-01$410.84$112.98RVU16C
2016-04-01$410.84$112.98RVU16B
2016-01-01$410.84$112.98RVU16A
2015-10-01$421.61$112.79RVU15D
2015-07-01$421.61$112.79RVU15C
2015-04-01$419.51$112.23RVU15B
2015-01-01$419.51$112.23RVU15A
2014-10-01$399.03$112.96RVU14D
2014-07-01$399.03$112.96RVU14C
2014-04-01$399.03$112.96RVU14B
2014-01-01$399.03$112.96RVU14A
2013-10-01$428.58$107.24RVU13D
2013-07-01$428.58$107.24RVU13C
2013-04-01$428.58$107.24RVU13B
2013-01-01$428.58$107.24RVU13AR

Price 32556 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

32556 billing questions

How do I choose between 32556 and 32557?

Use 32556 when the indwelling pleural catheter is placed without imaging guidance. Use 32557 when imaging guidance is used for placement.

Can I report 32556 for a thoracentesis?

No. A thoracentesis removes pleural fluid by aspiration without leaving an indwelling catheter; 32554 and 32555 distinguish aspiration without and with imaging guidance.

How is bilateral placement reported?

CMS lists 32556 as bilateral when modifier 50 is used, with payment at 150%. Document the service on each side.

What documentation supports 32556?

Document the clinical indication, the side treated, placement of the catheter in the pleural space, and that imaging guidance was not used.

Can an assistant or co-surgeon be paid for this service?

CMS restricts assistant-at-surgery payment for 32556. Co-surgeons and team surgery 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 32556PPRRVU2026_Oct_nonQPP.csv, line 3,735 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 32556 pays in Puerto Rico?

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

Fee sheets · Coming soon

Put 32556 and the rest of your codes on one sheet

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

Join the waitlist