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CPT code 32557: Pleural catheter, with imaging guidance2026 Medicare rate & RVUs in Idaho

Report percutaneous placement of an indwelling pleural catheter with imaging guidance to drain pleural fluid or air, such as an effusion or pneumothorax.

CMS RVU26DEffective Oct 1, 2026One payment locality31.8K Medicare services in 2024

In Idaho, Medicare pays $599.34 for 32557 in the office and $122.12 when it’s performed in a hospital or facility.

$599.34Office (non-facility)
$122.12Hospital or facility
−7.5%vs the national office rate ($647.98)

Check a contract rate as a % of Medicare · 32557 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 32557 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 32557 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 32557 covers

A clinician places a catheter through the chest wall into the pleural space using imaging to guide its position. The catheter remains in place to drain pleural fluid or air; common situations include a pleural effusion, empyema, or pneumothorax. The service is typically performed by a pulmonologist, interventional radiologist, or other clinician experienced in image-guided pleural procedures, often in a hospital or outpatient procedural setting. Imaging guidance is part of this service, rather than a separate placement without guidance.

Report this code when the procedure documents percutaneous catheter placement and imaging guidance; distinguish it from a one-time pleural aspiration and from placement by an open approach. The code has 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, 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.

How Idaho compares for 32557

Across 109 of 109 payment localities, the office rate for 32557 runs from $567.14 in Arkansas to $890.69 in San Benito County, CA. Idaho pays $599.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

32557 in Idaho vs other payment areas
  1. Idaho · this page$599.34
  2. Los Angeles, CA · California$746.42+$147.08
  3. Washington, DC area · District of Columbia$750.01+$150.67
  4. Miami, FL · Florida$686.78+$87.44
  5. Chicago, IL · Illinois$665.64+$66.30
  6. Manhattan, NY · New York$747.67+$148.33
  7. Alaska · Alaska$728.60+$129.26

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

Every other payment area

32557 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$576.27$122.39
ArkansasArkansas$567.14$121.56
ArizonaArizona$629.79$127.16
Bakersfield, CACalifornia$697.00$128.48
Chico, CACalifornia$695.99$127.48
El Centro, CACalifornia$696.04$127.53
Fresno, CACalifornia$695.99$127.48
Hanford, CACalifornia$695.99$127.48

32557 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.

$567.14

$793.34

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

View every state and territory as a table
32557 office rate range by state
State / territoryOffice rate rangeLocalities
AK$728.601
AL$576.271
AR$567.141
AZ$629.791
CA$695.99–$890.6929
CO$681.051
CT$693.551
DC$750.011
DE$640.951
FL$629.96–$686.783
GA$592.27–$659.062
GU$716.691
HI$716.691
IA$595.821
ID$599.341
IL$607.60–$671.654
IN$603.231
KS$591.111
KY$587.611
LA$585.94–$617.892
MA$675.74–$754.802
MD$654.51–$750.013
ME$600.98–$639.092
MI$602.82–$636.802
MN$655.741
MO$573.80–$622.303
MS$570.681
MT$647.961
NC$608.131
ND$641.431
NE$599.891
NH$668.551
NJ$702.37–$740.792
NM$605.751
NV$646.671
NY$617.93–$765.125
OH$601.481
OK$588.231
OR$642.56–$706.212
PA$603.47–$673.882
PR$653.701
RI$666.391
SC$605.631
SD$640.661
TN$594.151
TX$599.01–$677.988
UT$614.731
VA$635.63–$750.012
VI$653.701
VT$637.181
WA$675.04–$772.582
WI$617.861
WV$582.591
WY$645.111

See 32557 in every payment locality

How the 32557 rate is calculated

Each of 32557’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 · 32557

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.04

3.04 RVUs× 1.000 GPCI

Practice expense16.03

16.03 RVUs× 1.000 GPCI

Malpractice0.33

0.33 RVUs× 1.000 GPCI

Adjusted RVUs

19.4000

Conversion factor

$33.4009

Medicare rate

$647.98

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

The exact Idaho inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,736

Code
32557
Physician work
3.04
Practice expense
16.03
Malpractice
0.33

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 32557 in Idaho
ComponentRVULocality factorAdjusted
Physician work3.04× 1.0003.0400
Practice expense16.03× 0.92014.7476
Malpractice0.33× 0.4730.1561
Total RVUs17.9437
Conversion factor× 33.4009

Office rate, Idaho$599.34

Office: (3.04 × 1 + 16.03 × 0.92 + 0.33 × 0.473) × $33.4009 = $599.34

Facility: (3.04 × 1 + 0.5 × 0.92 + 0.33 × 0.473) × $33.4009 = $122.12

Open 32557 in the RVU calculator

Payment rules and modifiers for 32557

The CMS indicators that decide how 32557 is paid alongside other services.

CMS payment indicators · 32557

Pleural catheter, with 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

32557 without 50 · national office

$647.98

Pleural catheter, with imaging guidance

32557-50 · Bilateral: 150%

$971.97

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 32557

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

Codes related to 32557
CodeHow it relatesOffice range, Idaho
Same family
32556Pleural catheter, without imaging guidancePercutaneous indwelling pleural catheter placement without imaging guidance.$774.75
Used instead
32555Thoracentesis, with imaging guidancePleural aspiration with imaging guidance when a catheter is not left in place.$288.71
32550Pleural catheter, tunneled catheter with cuffTunneled pleural catheter placement for a different catheter approach.$723.49
32551Chest tube, open thoracostomyChest tube insertion by an open approach rather than percutaneous image-guided placement.No office rate

How 32557 has changed in Idaho

32557 · Office / nonfacility

$599.34

Effective 2026-10-01

The base rate is $32.68 higher than on 2025-10-01, moving from $566.66 to $599.34 (5.8%).

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

    $566.66changed to$599.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.12 changed to 3.04
    • Practice expense RVU 15.71 changed to 16.03
    • Malpractice RVU 0.29 changed to 0.33
    • Practice expense GPCI 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $597.35changed to$566.66

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 16.17 changed to 15.71
    • Malpractice RVU 0.31 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $587.60changed to$597.35

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $614.04changed to$587.60

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 16.65 changed to 16.17
    • Malpractice RVU 0.30 changed to 0.31
    • Practice expense GPCI 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461

  5. January 1, 2023

    RVU23A

    $631.14changed to$614.04

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 17.11 changed to 16.65
    • Malpractice RVU 0.27 changed to 0.30
    • Practice expense GPCI 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $615.73changed to$631.14

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 16.44 changed to 17.11
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $571.94changed to$615.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 14.16 changed to 16.44
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $528.97changed to$571.94

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.66 changed to 14.16
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $479.49changed to$528.97

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 11.16 changed to 12.66
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $476.41changed to$479.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.13 changed to 11.16
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $479.34changed to$476.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.27 changed to 11.13
    • Malpractice RVU 0.29 changed to 0.27
    • Practice expense GPCI 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $475.77changed to$479.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.10 changed to 11.27
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $473.40changed to$475.77

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $521.31changed to$473.40

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.35 changed to 11.10
    • Malpractice RVU 0.66 changed to 0.30
    • Practice expense GPCI 0.896 changed to 0.898
    • Malpractice GPCI 0.556 changed to 0.508

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $870.99changed to$521.31

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 24.68 changed to 12.35
    • Malpractice RVU 0.69 changed to 0.66
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.603 changed to 0.556

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $870.99

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$599.34$122.12RVU26D
2026-07-01$599.34$122.12RVU26C
2026-04-01$599.34$122.12RVU26B
2026-01-01$599.34$122.12RVU26A
2025-10-01$566.66$133.73RVU25D
2025-07-01$566.66$133.73RVU25C
2025-04-01$566.66$133.73RVU25B
2025-01-01$566.66$133.73RVU25A
2024-10-01$597.35$137.03RVU24D
2024-07-01$597.35$137.03RVU24C
2024-04-01$597.35$137.03RVU24B
2024-03-09$597.35$137.03RVU24AR
2024-01-01$587.60$134.79RVU24A
2023-10-01$614.04$139.24RVU23D
2023-07-01$614.04$139.24RVU23C
2023-04-01$614.04$139.24RVU23B
2023-01-01$614.04$139.24RVU23A
2022-10-01$631.14$141.30RVU22D
2022-07-01$631.14$141.30RVU22C
2022-04-01$631.14$141.30RVU22B
2022-01-01$631.14$141.30RVU22A
2021-10-01$615.73$142.63RVU21D
2021-07-01$615.73$142.63RVU21C
2021-04-01$615.73$142.63RVU21B
2021-01-01$615.73$142.63RVU21A
2020-10-01$571.94$149.56RVU20D
2020-07-01$571.94$149.56RVU20C
2020-04-01$571.94$149.56RVU20B
2020-01-01$571.94$149.56RVU20A
2019-10-01$528.97$149.93RVU19D
2019-07-01$528.97$149.93RVU19C
2019-04-01$528.97$149.93RVU19B
2019-01-01$528.97$149.93RVU19A
2018-10-01$479.49$149.91RVU18D
2018-07-01$479.49$149.91RVU18C
2018-04-01$479.49$149.91RVU18B
2018-01-01$479.49$149.91RVU18AR1
2017-10-01$476.41$150.51RVU17D
2017-07-01$476.41$150.51RVU17C
2017-04-01$476.41$150.51RVU17B
2017-01-01$476.41$150.51RVU17A
2016-10-01$479.34$150.42RVU16D
2016-07-01$479.34$150.42RVU16C
2016-04-01$479.34$150.42RVU16B
2016-01-01$479.34$150.42RVU16A
2015-10-01$475.77$151.47RVU15D
2015-07-01$475.77$151.47RVU15C
2015-04-01$473.40$150.72RVU15B
2015-01-01$473.40$150.72RVU15A
2014-10-01$521.31$157.33RVU14D
2014-07-01$521.31$157.33RVU14C
2014-04-01$521.31$157.33RVU14B
2014-01-01$521.31$157.33RVU14A
2013-10-01$870.99$152.85RVU13D
2013-07-01$870.99$152.85RVU13C
2013-04-01$870.99$152.85RVU13B
2013-01-01$870.99$152.85RVU13AR

Price 32557 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

32557 billing questions

How does this differ from 32556?

Both describe percutaneous placement of an indwelling pleural catheter. Use 32557 when imaging guidance is used; 32556 is the corresponding service without imaging guidance.

Can imaging guidance be billed separately?

Imaging guidance is included in 32557. Do not separately report guidance for the same catheter placement.

When is 32555 more appropriate?

32555 describes pleural aspiration with imaging guidance, rather than placement of a catheter that remains in the pleural space for drainage.

How is bilateral placement reported?

Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What documentation supports 32557?

Document the indication, percutaneous catheter placement into the pleural space, use of imaging guidance, and the catheter’s placement and intended 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
RVUs for 32557PPRRVU2026_Oct_nonQPP.csv, line 3,736 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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