CPT code 32609: Pleural biopsy, thoracoscopic approach2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $238.98 for 32609 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 32609 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 32609 covers

A thoracic surgeon uses a scope passed through the chest wall to inspect the pleural space and collect tissue from the pleura. This is commonly performed in a hospital operating room when imaging or prior evaluation shows pleural thickening, nodules, or an unexplained effusion and tissue is needed to investigate possible malignancy, infection, or another pleural disorder. The specimen is sent for pathologic examination.

Report the code when pleural tissue is sampled; the scope inspection needed to locate and obtain that sample is part of the service, rather than a separate diagnostic thoracoscopy. The operative report should identify the pleural target and document that tissue was collected. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. 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 32609

Across 109 of 109 payment localities, the facility rate for 32609 runs from $214.43 in Wisconsin to $302.98 in Alaska. Puerto Rico pays $238.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

32609 rates by state

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

See 32609 in every payment locality

How the 32609 rate is calculated

Each of 32609’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 32609

The CMS indicators that decide how 32609 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 32609

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

How 32609 has changed in Puerto Rico

Price 32609 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