CPT code 32604: Thoracoscopic biopsy, pericardial sac2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $445.80 for 32604 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 32604 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 32604 covers

A thoracic surgeon uses a thoracoscope through small chest incisions to inspect the operative field and take tissue from the pericardial sac. The biopsy may help evaluate suspected pericardial disease, including abnormal tissue or a process associated with a pericardial effusion. The service is generally performed in an operating room, commonly in a hospital setting, with the patient under anesthesia.

Select this code when the operative report documents thoracoscopic tissue sampling specifically from the pericardial sac; biopsies of pleura, lung, or mediastinum are described by different codes. The record should identify the sampled site and the biopsy performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; 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 Puerto Rico compares for 32604

Across 109 of 109 payment localities, the facility rate for 32604 runs from $392.49 in Wisconsin to $562.20 in Alaska. Puerto Rico pays $445.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

32604 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 32604 in every payment locality

How the 32604 rate is calculated

Each of 32604’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.

Payment rules and modifiers for 32604

The CMS indicators that decide how 32604 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 32604

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

How 32604 has changed in Puerto Rico

Price 32604 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates