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

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 Utah, Medicare pays $97.65 for 32561 in the office and $59.03 when it’s performed in a hospital or facility.

$97.65Office (non-facility)
$59.03Hospital or facility
−3.5%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 Utah
  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 Utah 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. Utah pays $97.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

32561 in Utah vs other payment areas
  1. Utah · this page$97.65
  2. Los Angeles, CA · California$110.67+$13.02
  3. Washington, DC area · District of Columbia$113.26+$15.61
  4. Miami, FL · Florida$110.95+$13.30
  5. Chicago, IL · Illinois$108.26+$10.61
  6. Manhattan, NY · New York$115.27+$17.62
  7. Alaska · Alaska$124.97+$27.32

Other areas in Utah 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 Utah 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

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 32561 in Utah
ComponentRVULocality factorAdjusted
Physician work1.36× 1.0001.3600
Practice expense1.52× 0.9401.4288
Malpractice0.15× 0.8980.1347
Total RVUs2.9235
Conversion factor× 33.4009

Office rate, Utah$97.65

Office: (1.36 × 1 + 1.52 × 0.94 + 0.15 × 0.898) × $33.4009 = $97.65

Facility: (1.36 × 1 + 0.29 × 0.94 + 0.15 × 0.898) × $33.4009 = $59.03

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, Utah
Same family
32562Pleural fibrinolysis, subsequent daySubsequent-day pleural fibrinolytic treatment; distinguish by treatment day.$88.58
Used instead
32560Chemical pleurodesis, via chest tube or catheterPleural-agent instillation for pleurodesis, with a different treatment goal.$262.34
32554Thoracentesis, without imaging guidancePleural fluid aspiration without imaging, rather than fibrinolysis through a drain.$248.15
32555Thoracentesis, with imaging guidanceImage-guided pleural fluid aspiration, rather than fibrinolysis through a drain.$296.42

How 32561 has changed in Utah

32561 · Office / nonfacility

$97.65

Effective 2026-10-01

The base rate is $8.64 higher than on 2025-10-01, moving from $89.01 to $97.65 (9.7%).

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

    $89.01changed to$97.65

    • 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 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $91.29changed to$89.01

    • 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

    $89.80changed to$91.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $91.00changed to$89.80

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $92.56changed to$91.00

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.25 changed to 1.24
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $91.80changed to$92.56

    • 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

    $92.75changed to$91.80

    • 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
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $93.81changed to$92.75

    • 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
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $93.71changed to$93.81

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $92.77changed to$93.71

    • 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
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $92.78changed to$92.77

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.10 changed to 1.09
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $93.53changed to$92.78

    • 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

    $93.07changed to$93.53

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $95.04changed to$93.07

    • 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
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $94.00changed to$95.04

    • 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
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $94.00

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$97.65$59.03RVU26D
2026-07-01$97.65$59.03RVU26C
2026-04-01$97.65$59.03RVU26B
2026-01-01$97.65$59.03RVU26A
2025-10-01$89.01$63.05RVU25D
2025-07-01$89.01$63.05RVU25C
2025-04-01$89.01$63.05RVU25B
2025-01-01$89.01$63.05RVU25A
2024-10-01$91.29$64.58RVU24D
2024-07-01$91.29$64.58RVU24C
2024-04-01$91.29$64.58RVU24B
2024-03-09$91.29$64.58RVU24AR
2024-01-01$89.80$63.52RVU24A
2023-10-01$91.00$65.58RVU23D
2023-07-01$91.00$65.58RVU23C
2023-04-01$91.00$65.58RVU23B
2023-01-01$91.00$65.58RVU23A
2022-10-01$92.56$66.80RVU22D
2022-07-01$92.56$66.80RVU22C
2022-04-01$92.56$66.80RVU22B
2022-01-01$92.56$66.80RVU22A
2021-10-01$91.80$66.79RVU21D
2021-07-01$91.80$66.79RVU21C
2021-04-01$91.80$66.79RVU21B
2021-01-01$91.80$66.79RVU21A
2020-10-01$92.75$69.10RVU20D
2020-07-01$92.75$69.10RVU20C
2020-04-01$92.75$69.10RVU20B
2020-01-01$92.75$69.10RVU20A
2019-10-01$93.81$70.76RVU19D
2019-07-01$93.81$70.76RVU19C
2019-04-01$93.81$70.76RVU19B
2019-01-01$93.81$70.76RVU19A
2018-10-01$93.71$70.68RVU18D
2018-07-01$93.71$70.68RVU18C
2018-04-01$93.71$70.68RVU18B
2018-01-01$93.71$70.68RVU18AR1
2017-10-01$92.77$70.86RVU17D
2017-07-01$92.77$70.86RVU17C
2017-04-01$92.77$70.86RVU17B
2017-01-01$92.77$70.86RVU17A
2016-10-01$92.78$70.66RVU16D
2016-07-01$92.78$70.66RVU16C
2016-04-01$92.78$70.66RVU16B
2016-01-01$92.78$70.66RVU16A
2015-10-01$93.53$71.33RVU15D
2015-07-01$93.53$71.33RVU15C
2015-04-01$93.07$70.98RVU15B
2015-01-01$93.07$70.98RVU15A
2014-10-01$95.04$73.64RVU14D
2014-07-01$95.04$73.64RVU14C
2014-04-01$95.04$73.64RVU14B
2014-01-01$95.04$73.64RVU14A
2013-10-01$94.00$70.94RVU13D
2013-07-01$94.00$70.94RVU13C
2013-04-01$94.00$70.94RVU13B
2013-01-01$94.00$70.94RVU13AR

Price 32561 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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 UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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