CPT code 32557: Pleural catheter, with imaging guidance2026 Medicare rate & RVUs in Texas
Report percutaneous placement of an indwelling pleural catheter with imaging guidance to drain pleural fluid or air, such as an effusion or pneumothorax.
Medicare pays $599.01–$677.98 for 32557 in the office in Texas, from Beaumont, TX to Austin, TX. 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 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.
Where 32557 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$599.01 to $677.98
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $677.98 | $129.18 |
| Beaumont, TX | $599.01 | $126.98 |
| Brazoria, TX | $641.55 | $127.50 |
| Dallas, TX | $645.18 | $128.54 |
| Fort Worth, TX | $639.97 | $128.52 |
| Galveston, TX | $643.15 | $128.06 |
| Houston, TX | $649.19 | $134.10 |
| Rest of Texas | $619.60 | $127.34 |
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
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.
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
| 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
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).
32557 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 32556Pleural catheterWithout imaging guidance
- Choose 32557 when imaging guides the percutaneous catheter placement. Choose 32556 when the same type of placement is performed without imaging guidance.
- 32555ThoracentesisWith imaging guidance
- 32555 is pleural aspiration with imaging guidance; 32557 involves placing an indwelling catheter for drainage.
- 32550Pleural catheterTunneled catheter with cuff
- 32550 describes tunneled pleural catheter placement. 32557 describes percutaneous catheter placement with imaging guidance, not a tunneled catheter service.
- 32551Chest tubeOpen thoracostomy
- 32551 is chest tube insertion through an open approach. Use 32557 for percutaneous catheter placement with imaging guidance.
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
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