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CPT code 32561: Pleural fibrinolysis, initial day2026 Medicare rate & RVUs in Fort Worth, TX

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 Fort Worth, TX, Medicare pays $100.26 for 32561 in the office and $59.75 when it’s performed in a hospital or facility.

$100.26Office (non-facility)
$59.75Hospital or facility
−0.9%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 Fort Worth, TX
  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 Fort Worth, TX 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. Fort Worth, TX pays $100.26. The RVUs are the same everywhere; the geographic indexes change the dollars.

32561 in Fort Worth, TX vs other payment areas
  1. Fort Worth, TX · this page$100.26
  2. Austin, TX · Texas$103.67+$3.41
  3. Beaumont, TX · Texas$96.28−$3.98
  4. Brazoria, TX · Texas$100.01−$0.25
  5. Dallas, TX · Texas$100.70+$0.44
  6. Galveston, TX · Texas$100.35+$0.09
  7. Houston, TX · Texas$103.10+$2.84

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

Every other payment area

32561 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$98.13$59.14
Los Angeles, CACalifornia$110.67$62.07
Washington, DC areaDistrict of Columbia$113.26$64.86
Miami, FLFlorida$110.95$68.18
Chicago, ILIllinois$108.26$66.98
Manhattan, NYNew York$115.27$67.53
AlaskaAlaska$124.97$81.21
AlabamaAlabama$92.68$56.74

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 Fort Worth, TX 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

100

Locality
Fort Worth, TX
Physician work
1.009
Practice expense
0.986
Malpractice
0.871
Office calculation for 32561 in Fort Worth, TX
ComponentRVULocality factorAdjusted
Physician work1.36× 1.0091.3722
Practice expense1.52× 0.9861.4987
Malpractice0.15× 0.8710.1306
Total RVUs3.0016
Conversion factor× 33.4009

Office rate, Fort Worth, TX$100.26

Office: (1.36 × 1.009 + 1.52 × 0.986 + 0.15 × 0.871) × $33.4009 = $100.26

Facility: (1.36 × 1.009 + 0.29 × 0.986 + 0.15 × 0.871) × $33.4009 = $59.75

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, Fort Worth, TX
Same family
32562Pleural fibrinolysis, subsequent daySubsequent-day pleural fibrinolytic treatment; distinguish by treatment day.$91.00
Used instead
32560Chemical pleurodesis, via chest tube or catheterPleural-agent instillation for pleurodesis, with a different treatment goal.$272.63
32554Thoracentesis, without imaging guidancePleural fluid aspiration without imaging, rather than fibrinolysis through a drain.$257.43
32555Thoracentesis, with imaging guidanceImage-guided pleural fluid aspiration, rather than fibrinolysis through a drain.$307.46

How 32561 has changed in Fort Worth, TX

32561 · Office / nonfacility

$100.26

Effective 2026-10-01

The base rate is $8.17 higher than on 2025-10-01, moving from $92.09 to $100.26 (8.9%).

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

    $92.09changed to$100.26

    • 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
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 0.998 changed to 0.986
    • Malpractice GPCI 0.902 changed to 0.871

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $94.44changed to$92.09

    • 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

    $92.90changed to$94.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $93.72changed to$92.90

    • 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
    • Work GPCI 1.013 changed to 1.011
    • Practice expense GPCI 0.996 changed to 0.998
    • Malpractice GPCI 0.721 changed to 0.902

  5. January 1, 2023

    RVU23A

    $95.08changed to$93.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.25 changed to 1.24
    • Work GPCI 1.016 changed to 1.013
    • Practice expense GPCI 0.995 changed to 0.996
    • Malpractice GPCI 0.539 changed to 0.721

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $94.46changed to$95.08

    • 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

    $94.50changed to$94.46

    • 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 1.011 changed to 1.016
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.643 changed to 0.539

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $94.28changed to$94.50

    • 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 1.007 changed to 1.011
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.747 changed to 0.643

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $94.18changed to$94.28

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $93.32changed to$94.18

    • 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 1.006 changed to 1.007
    • Practice expense GPCI 0.991 changed to 0.986
    • Malpractice GPCI 0.760 changed to 0.747

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $93.63changed to$93.32

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.10 changed to 1.09
    • Work GPCI 1.005 changed to 1.006
    • Practice expense GPCI 0.995 changed to 0.991
    • Malpractice GPCI 0.772 changed to 0.760

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $94.24changed to$93.63

    • 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

    $93.77changed to$94.24

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $95.02changed to$93.77

    • 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 1.002 changed to 1.005
    • Practice expense GPCI 0.987 changed to 0.995
    • Malpractice GPCI 0.799 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $94.34changed to$95.02

    • 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 1.002
    • Practice expense GPCI 0.979 changed to 0.987
    • Malpractice GPCI 0.826 changed to 0.799

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $94.34

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$100.26$59.75RVU26D
2026-07-01$100.26$59.75RVU26C
2026-04-01$100.26$59.75RVU26B
2026-01-01$100.26$59.75RVU26A
2025-10-01$92.09$64.33RVU25D
2025-07-01$92.09$64.33RVU25C
2025-04-01$92.09$64.33RVU25B
2025-01-01$92.09$64.33RVU25A
2024-10-01$94.44$65.87RVU24D
2024-07-01$94.44$65.87RVU24C
2024-04-01$94.44$65.87RVU24B
2024-03-09$94.44$65.87RVU24AR
2024-01-01$92.90$64.79RVU24A
2023-10-01$93.72$66.38RVU23D
2023-07-01$93.72$66.38RVU23C
2023-04-01$93.72$66.38RVU23B
2023-01-01$93.72$66.38RVU23A
2022-10-01$95.08$67.19RVU22D
2022-07-01$95.08$67.19RVU22C
2022-04-01$95.08$67.19RVU22B
2022-01-01$95.08$67.19RVU22A
2021-10-01$94.46$67.37RVU21D
2021-07-01$94.46$67.37RVU21C
2021-04-01$94.46$67.37RVU21B
2021-01-01$94.46$67.37RVU21A
2020-10-01$94.50$69.11RVU20D
2020-07-01$94.50$69.11RVU20C
2020-04-01$94.50$69.11RVU20B
2020-01-01$94.50$69.11RVU20A
2019-10-01$94.28$69.76RVU19D
2019-07-01$94.28$69.76RVU19C
2019-04-01$94.28$69.76RVU19B
2019-01-01$94.28$69.76RVU19A
2018-10-01$94.18$69.69RVU18D
2018-07-01$94.18$69.69RVU18C
2018-04-01$94.18$69.69RVU18B
2018-01-01$94.18$69.69RVU18AR1
2017-10-01$93.32$69.84RVU17D
2017-07-01$93.32$69.84RVU17C
2017-04-01$93.32$69.84RVU17B
2017-01-01$93.32$69.84RVU17A
2016-10-01$93.63$69.76RVU16D
2016-07-01$93.63$69.76RVU16C
2016-04-01$93.63$69.76RVU16B
2016-01-01$93.63$69.76RVU16A
2015-10-01$94.24$70.29RVU15D
2015-07-01$94.24$70.29RVU15C
2015-04-01$93.77$69.94RVU15B
2015-01-01$93.77$69.94RVU15A
2014-10-01$95.02$72.03RVU14D
2014-07-01$95.02$72.03RVU14C
2014-04-01$95.02$72.03RVU14B
2014-01-01$95.02$72.03RVU14A
2013-10-01$94.34$69.69RVU13D
2013-07-01$94.34$69.69RVU13C
2013-04-01$94.34$69.69RVU13B
2013-01-01$94.34$69.69RVU13AR

Price 32561 for an earlier date of service

Where the Fort Worth, TX rate applies

Fort Worth, TX is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Fort Worth, TXGPCI2026.csv, line 100 (RVU26D)

Open CMS sourceHow we calculate rates

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