CPT code 32651: Thoracoscopic decortication, partial decortication2026 Medicare rate & RVUs

Medicare pays $1,039.77 for 32651 nationally in a facility.

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

What 32651 covers

A thoracic surgeon uses thoracoscopy to remove part of a fibrous peel restricting lung expansion. The operation may be performed for organized empyema or fibrothorax when pleural scarring limits re-expansion. It is typically done in a hospital operating room, often with the patient under general anesthesia. The operative report should describe the pleural disease, the area treated, and the extent of decortication performed.

Report this code when the surgeon performs partial pulmonary decortication, not merely pleural inspection, biopsy, or removal of loose material. The documented extent distinguishes partial decortication from total decortication, reported with 32652. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.

Where 32651 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

32651 rates by state

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

How the 32651 rate is calculated

Each of 32651’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 32651

32651 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

32651 compared with similar codes

How to choose

32652Thoracoscopic decorticationTotal pulmonary decortication

32651 represents partial pulmonary decortication; 32652 is the corresponding code when the surgeon performs total decortication.

32653Thoracoscopy removalForeign body or fibrin

Use 32653 for removal of a foreign body or fibrin deposit from the pleural space. Use 32651 when the operation is partial decortication of the lung.

32650PleurodesisThoracoscopic approach

32650 describes thoracoscopic pleurodesis, not removal of a restrictive pleural peel to free the lung.

32656Thoracoscopic pleurectomyParietal pleura removal

32656 is for thoracoscopic pleurectomy. Distinguish it from 32651 by the procedure actually performed and documented.

Codes related to 32651

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

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