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CPT code 32561: Pleural fibrinolysis, initial day2026 Medicare rate & RVUs in Nevada

Reports initial-day instillation of a fibrinolytic through a chest tube or catheter to help clear a loculated pleural fluid collection.

CMS RVU26DEffective Oct 1, 2026One payment locality4.5K Medicare services in 2024

In Nevada, Medicare pays $100.42 for 32561 in the office and $59.29 when it’s performed in a hospital or facility.

$100.42Office (non-facility)
$59.29Hospital or facility
−0.8%vs the national office rate ($101.20)

Check a contract rate as a % of Medicare · 32561 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 32561 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 32561 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 32561 covers

A physician or other qualified practitioner instills a fibrinolytic agent, such as alteplase, through a chest tube or pleural catheter to help break down fibrin in a loculated pleural collection. This treatment may be used for a complex effusion or empyema when fluid is divided by fibrinous septations. It is performed in settings where the patient can receive care through the pleural drain; the code describes the instillation, not placement of the tube or catheter.

Report 32561 for the initial treatment day. For a later treatment day, use the subsequent-day code 32562 rather than reporting another initial-day service. Documentation should identify the pleural indication, the fibrinolytic administered, the catheter route, and the treatment date. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 Nevada compares for 32561

Across 109 of 109 payment localities, the office rate for 32561 runs from $91.62 in Arkansas to $126.32 in San Benito County, CA. Nevada pays $100.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

32561 in Nevada vs other payment areas
  1. Nevada · this page$100.42
  2. Los Angeles, CA · California$110.67+$10.25
  3. Washington, DC area · District of Columbia$113.26+$12.84
  4. Miami, FL · Florida$110.95+$10.53
  5. Chicago, IL · Illinois$108.26+$7.84
  6. Manhattan, NY · New York$115.27+$14.85
  7. Alaska · Alaska$124.97+$24.55

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

Every other payment area

32561 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$92.68$56.74
ArkansasArkansas$91.62$56.33
ArizonaArizona$98.91$59.10
Bakersfield, CACalifornia$104.98$59.96
Chico, CACalifornia$104.53$59.50
El Centro, CACalifornia$104.55$59.52
Fresno, CACalifornia$104.53$59.50
Hanford, CACalifornia$104.53$59.50

32561 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.

$91.62

$124.97

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

View every state and territory as a table
32561 office rate range by state
State / territoryOffice rate rangeLocalities
AK$124.971
AL$92.681
AR$91.621
AZ$98.911
CA$104.53–$126.3229
CO$103.901
CT$107.071
DC$113.261
DE$100.321
FL$101.49–$110.953
GA$96.68–$103.162
GU$106.051
HI$106.051
IA$93.871
ID$94.501
IL$99.61–$108.264
IN$94.921
KS$93.851
KY$95.141
LA$95.16–$98.892
MA$103.61–$112.372
MD$101.86–$113.263
ME$95.25–$98.902
MI$97.43–$102.862
MN$99.151
MO$94.07–$98.783
MS$92.841
MT$101.191
NC$95.991
ND$98.231
NE$94.181
NH$102.661
NJ$108.18–$112.532
NM$98.001
NV$100.421
NY$97.18–$118.005
OH$96.831
OK$94.661
OR$99.51–$106.282
PA$96.77–$105.072
PR$101.691
RI$103.201
SC$96.591
SD$97.881
TN$94.271
TX$96.28–$103.678
UT$97.651
VA$98.87–$113.262
VI$101.691
VT$98.221
WA$103.29–$114.082
WI$95.611
WV$96.711
WY$99.901

See 32561 in every payment locality

How the 32561 rate is calculated

Each of 32561’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 · 32561

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.36

1.36 RVUs× 1.000 GPCI

Practice expense1.52

1.52 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

3.0300

Conversion factor

$33.4009

Medicare rate

$101.20

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

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,738

Code
32561
Physician work
1.36
Practice expense
1.52
Malpractice
0.15

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 32561 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.36× 1.0001.3600
Practice expense1.52× 1.0011.5215
Malpractice0.15× 0.8330.1249
Total RVUs3.0065
Conversion factor× 33.4009

Office rate, Nevada$100.42

Office: (1.36 × 1 + 1.52 × 1.001 + 0.15 × 0.833) × $33.4009 = $100.42

Facility: (1.36 × 1 + 0.29 × 1.001 + 0.15 × 0.833) × $33.4009 = $59.29

Open 32561 in the RVU calculator

Payment rules and modifiers for 32561

The CMS indicators that decide how 32561 is paid alongside other services.

CMS payment indicators · 32561

Pleural fibrinolysis, initial day

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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

32561 without 51 · national office

$101.20

Pleural fibrinolysis, initial day

32561-51 · Second procedure: 50%

$50.60

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 32561

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

Codes related to 32561
CodeHow it relatesOffice range, Nevada
Same family
32562Pleural fibrinolysis, subsequent daySubsequent-day pleural fibrinolytic treatment; distinguish by treatment day.$91.17
Used instead
32560Chemical pleurodesis, via chest tube or catheterPleural-agent instillation for pleurodesis, with a different treatment goal.$275.16
32554Thoracentesis, without imaging guidancePleural fluid aspiration without imaging, rather than fibrinolysis through a drain.$259.55
32555Thoracentesis, with imaging guidanceImage-guided pleural fluid aspiration, rather than fibrinolysis through a drain.$309.97

How 32561 has changed in Nevada

32561 · Office / nonfacility

$100.42

Effective 2026-10-01

The base rate is $9.04 higher than on 2025-10-01, moving from $91.38 to $100.42 (9.9%).

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

    $91.38changed to$100.42

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.39 changed to 1.36
    • Practice expense RVU 1.30 changed to 1.52
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $93.71changed to$91.38

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.29 changed to 1.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $92.18changed to$93.71

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $95.45changed to$92.18

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.24 changed to 1.29
    • Malpractice RVU 0.17 changed to 0.16
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $99.55changed to$95.45

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.25 changed to 1.24
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $98.38changed to$99.55

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.22 changed to 1.25
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $96.81changed to$98.38

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.14 changed to 1.22
    • Malpractice RVU 0.13 changed to 0.15
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $96.16changed to$96.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.12 changed to 1.14
    • Malpractice RVU 0.15 changed to 0.13
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $96.05changed to$96.16

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $95.97changed to$96.05

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.09 changed to 1.12
    • Malpractice RVU 0.16 changed to 0.15
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $97.04changed to$95.97

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.10 changed to 1.09
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $97.74changed to$97.04

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $97.25changed to$97.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $100.16changed to$97.25

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.09 changed to 1.10
    • Malpractice RVU 0.23 changed to 0.17
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $100.91changed to$100.16

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.21 changed to 1.09
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$100.91

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$100.42$59.29RVU26D
2026-07-01$100.42$59.29RVU26C
2026-04-01$100.42$59.29RVU26B
2026-01-01$100.42$59.29RVU26A
2025-10-01$91.38$63.56RVU25D
2025-07-01$91.38$63.56RVU25C
2025-04-01$91.38$63.56RVU25B
2025-01-01$91.38$63.56RVU25A
2024-10-01$93.71$65.08RVU24D
2024-07-01$93.71$65.08RVU24C
2024-04-01$93.71$65.08RVU24B
2024-03-09$93.71$65.08RVU24AR
2024-01-01$92.18$64.02RVU24A
2023-10-01$95.45$68.00RVU23D
2023-07-01$95.45$68.00RVU23C
2023-04-01$95.45$68.00RVU23B
2023-01-01$95.45$68.00RVU23A
2022-10-01$99.55$71.52RVU22D
2022-07-01$99.55$71.52RVU22C
2022-04-01$99.55$71.52RVU22B
2022-01-01$99.55$71.52RVU22A
2021-10-01$98.38$71.17RVU21D
2021-07-01$98.38$71.17RVU21C
2021-04-01$98.38$71.17RVU21B
2021-01-01$98.38$71.17RVU21A
2020-10-01$96.81$71.19RVU20D
2020-07-01$96.81$71.19RVU20C
2020-04-01$96.81$71.19RVU20B
2020-01-01$96.81$71.19RVU20A
2019-10-01$96.16$70.87RVU19D
2019-07-01$96.16$70.87RVU19C
2019-04-01$96.16$70.87RVU19B
2019-01-01$96.16$70.87RVU19A
2018-10-01$96.05$70.79RVU18D
2018-07-01$96.05$70.79RVU18C
2018-04-01$96.05$70.79RVU18B
2018-01-01$96.05$70.79RVU18AR1
2017-10-01$95.97$71.47RVU17D
2017-07-01$95.97$71.47RVU17C
2017-04-01$95.97$71.47RVU17B
2017-01-01$95.97$71.47RVU17A
2016-10-01$97.04$71.82RVU16D
2016-07-01$97.04$71.82RVU16C
2016-04-01$97.04$71.82RVU16B
2016-01-01$97.04$71.82RVU16A
2015-10-01$97.74$72.44RVU15D
2015-07-01$97.74$72.44RVU15C
2015-04-01$97.25$72.08RVU15B
2015-01-01$97.25$72.08RVU15A
2014-10-01$100.16$75.59RVU14D
2014-07-01$100.16$75.59RVU14C
2014-04-01$100.16$75.59RVU14B
2014-01-01$100.16$75.59RVU14A
2013-10-01$100.91$74.27RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 32561 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

32561 billing questions

When should 32561 be used instead of 32562?

Use 32561 for the initial day of pleural fibrinolytic treatment. Use 32562 for treatment on a subsequent day.

Does 32561 include placing the chest tube?

No. It reports fibrinolytic instillation through a chest tube or catheter, not insertion of that access device.

What should the record support?

Document the pleural condition being treated, the fibrinolytic agent, its administration through the drain, and whether this is the initial or a subsequent treatment day.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the 0-day global period affect billing?

Same-day preoperative and postoperative care is included in the procedure. Care on a later date is outside that 0-day global period.

Can an assistant or another surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.

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 32561PPRRVU2026_Oct_nonQPP.csv, line 3,738 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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