CPT code 32608: Thoracoscopic biopsy, pulmonary nodule or mass2026 Medicare rate & RVUs in Virgin Islands, VI
Reports surgical thoracoscopy to obtain biopsy tissue from a pulmonary nodule or mass when a diagnostic sample is needed.
In Virgin Islands, VI, Medicare pays $353.03 for 32608 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 32608 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 32608 covers
This service involves using a thoracoscope to locate and sample a nodule or mass in the lung. Thoracic surgeons commonly perform it in the operating room when imaging has identified a lung lesion that needs tissue diagnosis. The biopsy specimen is submitted for examination; this code describes sampling the lung lesion, not removing it by wedge resection.
Select this code when the operative report supports biopsy of a pulmonary nodule or mass, rather than biopsy of an infiltrate, pleura, or mediastinal structure. Document the target and the biopsy performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment 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 Virgin Islands, VI compares for 32608
Across 109 of 109 payment localities, the facility rate for 32608 runs from $311.32 in Wisconsin to $444.24 in Alaska. Virgin Islands, VI pays $353.03. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virgin Islands, VI · this page$353.03
- Los Angeles, CA · California$357.07+$4.04
- Washington, DC area · District of Columbia$384.64+$31.61
- Miami, FL · Florida$441.39+$88.36
- Chicago, IL · Illinois$427.21+$74.18
- Manhattan, NY · New York$412.06+$59.03
- Alaska · Alaska$444.24+$91.21
Other areas in United States Virgin Islands first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $319.53 |
| ArkansasArkansas | — | $315.49 |
| ArizonaArizona | — | $342.71 |
| Bakersfield, CACalifornia | — | $342.62 |
| Chico, CACalifornia | — | $338.10 |
| El Centro, CACalifornia | — | $338.38 |
| Fresno, CACalifornia | — | $338.10 |
| Hanford, CACalifornia | — | $338.10 |
| Madera, CACalifornia | — | $338.10 |
| Merced, CACalifornia | — | $338.10 |
| Modesto, CACalifornia | — | $338.10 |
| Napa, CACalifornia | — | $363.33 |
| Oxnard, CACalifornia | — | $351.81 |
| Redding, CACalifornia | — | $338.10 |
| Rest of CaliforniaCalifornia | — | $338.10 |
| Riverside, CACalifornia | — | $356.01 |
| Sacramento, CACalifornia | — | $347.33 |
| Salinas, CACalifornia | — | $345.92 |
| San Diego, CACalifornia | — | $348.78 |
| Marin County, CACalifornia | — | $374.57 |
| San Francisco, CACalifornia | — | $372.68 |
| San Benito County, CACalifornia | — | $384.59 |
| Santa Clara County, CACalifornia | — | $376.84 |
| San Luis Obispo, CACalifornia | — | $341.31 |
| Santa Cruz, CACalifornia | — | $347.86 |
| Santa Maria, CACalifornia | — | $345.77 |
| Santa Rosa, CACalifornia | — | $350.83 |
| Stockton, CACalifornia | — | $338.10 |
| Vallejo, CACalifornia | — | $360.59 |
| Visalia, CACalifornia | — | $338.10 |
| Yuba City, CACalifornia | — | $338.10 |
| ColoradoColorado | — | $348.27 |
| ConnecticutConnecticut | — | $374.95 |
| DelawareDelaware | — | $347.63 |
| Fort Lauderdale, FLFlorida | — | $399.09 |
| Rest of FloridaFlorida | — | $377.83 |
| Atlanta, GAGeorgia | — | $366.12 |
| Rest of GeorgiaGeorgia | — | $355.71 |
| Hawaii, Guam, HIHawaii | — | $339.77 |
| IowaIowa | — | $313.08 |
| IdahoIdaho | — | $317.69 |
| East St. Louis, ILIllinois | — | $403.65 |
| Rest of IllinoisIllinois | — | $377.97 |
| Suburban Chicago, ILIllinois | — | $399.68 |
| IndianaIndiana | — | $318.94 |
| KansasKansas | — | $318.23 |
| KentuckyKentucky | — | $340.04 |
| New Orleans, LALouisiana | — | $356.24 |
| Rest of LouisianaLouisiana | — | $342.14 |
| Metropolitan Boston, MAMassachusetts | — | $370.50 |
| Rest of MassachusettsMassachusetts | — | $349.24 |
| Baltimore area, MDMaryland | — | $375.27 |
| Rest of MarylandMaryland | — | $351.60 |
| Rest of MaineMaine | — | $326.00 |
| Southern Maine, MEMaine | — | $331.79 |
| Detroit, MIMichigan | — | $388.71 |
| Rest of MichiganMichigan | — | $353.76 |
| MinnesotaMinnesota | — | $315.94 |
| Metropolitan Kansas City, MOMissouri | — | $347.22 |
| Metropolitan St. Louis, MOMissouri | — | $349.58 |
| Rest of MissouriMissouri | — | $341.32 |
| MississippiMississippi | — | $328.14 |
| MontanaMontana | — | $352.94 |
| North CarolinaNorth Carolina | — | $327.92 |
| North DakotaNorth Dakota | — | $319.91 |
| NebraskaNebraska | — | $312.62 |
| New HampshireNew Hampshire | — | $349.13 |
| Northern New JerseyNew Jersey | — | $382.79 |
| Rest of New JerseyNew Jersey | — | $374.22 |
| New MexicoNew Mexico | — | $358.08 |
| NevadaNevada | — | $343.81 |
| NYC suburbs and Long Island, NYNew York | — | $429.19 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $381.86 |
| Queens, NYNew York | — | $405.52 |
| Rest of New YorkNew York | — | $332.76 |
| OhioOhio | — | $347.01 |
| OklahomaOklahoma | — | $332.64 |
| Portland, OROregon | — | $350.60 |
| Rest of OregonOregon | — | $336.18 |
| Metropolitan Philadelphia, PAPennsylvania | — | $370.88 |
| Rest of PennsylvaniaPennsylvania | — | $343.87 |
| Puerto RicoPuerto Rico | — | $353.03 |
| Rhode IslandRhode Island | — | $353.71 |
| South CarolinaSouth Carolina | — | $339.02 |
| South DakotaSouth Dakota | — | $316.01 |
| TennesseeTennessee | — | $320.44 |
| Austin, TXTexas | — | $351.45 |
| Beaumont, TXTexas | — | $342.38 |
| Brazoria, TXTexas | — | $341.89 |
| Dallas, TXTexas | — | $346.83 |
| Fort Worth, TXTexas | — | $346.81 |
| Galveston, TXTexas | — | $344.71 |
| Houston, TXTexas | — | $375.28 |
| Rest of TexasTexas | — | $343.84 |
| UtahUtah | — | $342.89 |
| VirginiaVirginia | — | $335.38 |
| VermontVermont | — | $324.75 |
| Rest of WashingtonWashington | — | $346.56 |
| King County, WAWashington | — | $370.89 |
| WisconsinWisconsin | — | $311.32 |
| West VirginiaWest Virginia | — | $367.33 |
| WyomingWyoming | — | $338.54 |
32608 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 32608 rate is calculated
Each of 32608’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 · 32608
RVUs × geographic indexes × conversion factor
Work6.67
6.67 RVUs× 1.000 GPCI
Practice expense2.23
2.23 RVUs× 1.000 GPCI
Malpractice1.67
1.67 RVUs× 1.000 GPCI
Adjusted RVUs
10.5700
Conversion factor
$33.4009
Medicare rate
$353.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virgin Islands, VI inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,744
- Code
- 32608
- Physician work
- 6.67
- Practice expense
- 2.23
- Malpractice
- 1.67
GPCI2026.csv
107
- Locality
- Virgin Islands, VI
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.67 | × 1.000 | 6.6700 |
| Practice expense | 2.23 | × 1.011 | 2.2545 |
| Malpractice | 1.67 | × 0.985 | 1.6449 |
| Total RVUs | 10.5695 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Virgin Islands, VI$353.03
Facility: (6.67 × 1 + 2.23 × 1.011 + 1.67 × 0.985) × $33.4009 = $353.03
Payment rules and modifiers for 32608
The CMS indicators that decide how 32608 is paid alongside other services.
CMS payment indicators · 32608
Thoracoscopic biopsy, pulmonary nodule or mass
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| 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 51 · payment effect
With and without the modifier
32608 without 51 · national facility
$353.05
Thoracoscopic biopsy, pulmonary nodule or mass
32608-51 · Second procedure: 50%
$176.53
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%).
How 32608 has changed in Virgin Islands, VI
32608 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $353.03 | RVU26D |
| 2026-07-01 | Not available in this setting | $353.03 | RVU26C |
| 2026-04-01 | Not available in this setting | $353.03 | RVU26B |
| 2026-01-01 | Not available in this setting | $353.03 | RVU26A |
| 2025-10-01 | Not available in this setting | $362.24 | RVU25D |
| 2025-07-01 | Not available in this setting | $362.24 | RVU25C |
| 2025-04-01 | Not available in this setting | $362.24 | RVU25B |
| 2025-01-01 | Not available in this setting | $362.24 | RVU25A |
| 2024-10-01 | Not available in this setting | $370.76 | RVU24D |
| 2024-07-01 | Not available in this setting | $370.76 | RVU24C |
| 2024-04-01 | Not available in this setting | $370.76 | RVU24B |
| 2024-03-09 | Not available in this setting | $370.76 | RVU24AR |
| 2024-01-01 | Not available in this setting | $364.71 | RVU24A |
| 2023-10-01 | Not available in this setting | $375.99 | RVU23D |
| 2023-07-01 | Not available in this setting | $376.15 | RVU23C |
| 2023-04-01 | Not available in this setting | $376.15 | RVU23B |
| 2023-01-01 | Not available in this setting | $376.15 | RVU23A |
| 2022-10-01 | Not available in this setting | $384.07 | RVU22D |
| 2022-07-01 | Not available in this setting | $384.07 | RVU22C |
| 2022-04-01 | Not available in this setting | $384.07 | RVU22B |
| 2022-01-01 | Not available in this setting | $384.07 | RVU22A |
| 2021-10-01 | Not available in this setting | $385.88 | RVU21D |
| 2021-07-01 | Not available in this setting | $385.88 | RVU21C |
| 2021-04-01 | Not available in this setting | $385.88 | RVU21B |
| 2021-01-01 | Not available in this setting | $385.88 | RVU21A |
| 2020-10-01 | Not available in this setting | $395.61 | RVU20D |
| 2020-07-01 | Not available in this setting | $395.61 | RVU20C |
| 2020-04-01 | Not available in this setting | $395.61 | RVU20B |
| 2020-01-01 | Not available in this setting | $395.61 | RVU20A |
| 2019-10-01 | Not available in this setting | $393.28 | RVU19D |
| 2019-07-01 | Not available in this setting | $393.28 | RVU19C |
| 2019-04-01 | Not available in this setting | $393.28 | RVU19B |
| 2019-01-01 | Not available in this setting | $393.28 | RVU19A |
| 2018-10-01 | Not available in this setting | $393.21 | RVU18D |
| 2018-07-01 | Not available in this setting | $393.21 | RVU18C |
| 2018-04-01 | Not available in this setting | $393.21 | RVU18B |
| 2018-01-01 | Not available in this setting | $393.21 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $393.87 | RVU17D |
| 2017-07-01 | Not available in this setting | $393.87 | RVU17C |
| 2017-04-01 | Not available in this setting | $393.87 | RVU17B |
| 2017-01-01 | Not available in this setting | $393.87 | RVU17A |
| 2016-10-01 | Not available in this setting | $390.23 | RVU16D |
| 2016-07-01 | Not available in this setting | $390.23 | RVU16C |
| 2016-04-01 | Not available in this setting | $390.23 | RVU16B |
| 2016-01-01 | Not available in this setting | $390.23 | RVU16A |
| 2015-10-01 | Not available in this setting | $392.00 | RVU15D |
| 2015-07-01 | Not available in this setting | $392.00 | RVU15C |
| 2015-04-01 | Not available in this setting | $390.05 | RVU15B |
| 2015-01-01 | Not available in this setting | $390.05 | RVU15A |
| 2014-10-01 | Not available in this setting | $394.59 | RVU14D |
| 2014-07-01 | Not available in this setting | $394.59 | RVU14C |
| 2014-04-01 | Not available in this setting | $394.59 | RVU14B |
| 2014-01-01 | Not available in this setting | $394.59 | RVU14A |
| 2013-10-01 | Not available in this setting | $401.90 | RVU13D |
| 2013-07-01 | Not available in this setting | $401.90 | RVU13C |
| 2013-04-01 | Not available in this setting | $401.90 | RVU13B |
| 2013-01-01 | Not available in this setting | $401.90 | RVU13AR |
Where the Virgin Islands, VI rate applies
Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.
- Charlotte Amalie
- Charlotte Amalie East
- Charlotte Amalie West
- Christiansted
- Coral Bay
- Cruz Bay
- Frederiksted
- Frederiksted Southeast
32608 billing questions
When should 32608 be chosen over 32607?
Use 32608 for biopsy of a pulmonary nodule or mass. Code 32607 describes biopsy of a lung infiltrate.
How does 32608 differ from a diagnostic wedge resection?
32608 represents biopsy sampling of a nodule or mass. When the surgeon performs a diagnostic wedge resection, consider 32668 instead.
Is same-day preoperative or postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can modifier 50 be used for nodules in both lungs?
No. Modifier 50 is inappropriate for this descriptor and anatomy; document the biopsy site or sites and the procedure performed.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when the record documents medical necessity. Co-surgeon and team-surgery payment are not permitted.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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
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