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

Thoracoscopic partial lung decortication removes a restrictive pleural peel to free the lung, commonly during operative treatment of organized empyema or fibrothorax.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In Delaware, Medicare pays $1,024.16 for 32651 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,024.16Hospital or facility

Check a contract rate as a % of Medicare · 32651 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 32651 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 32651 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 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.

How Delaware compares for 32651

Across 109 of 109 payment localities, the facility rate for 32651 runs from $923.00 in Wisconsin to $1,295.27 in Alaska. Delaware pays $1,024.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

32651 in Delaware vs other payment areas
  1. Delaware · this page$1,024.16
  2. Los Angeles, CA · California$1,064.33+$40.17
  3. Washington, DC area · District of Columbia$1,139.14+$114.98
  4. Miami, FL · Florida$1,283.46+$259.30
  5. Chicago, IL · Illinois$1,242.24+$218.08
  6. Manhattan, NY · New York$1,212.72+$188.56
  7. Alaska · Alaska$1,295.27+$271.11

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

32651 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$939.29
ArkansasArkansas—$927.11
ArizonaArizona—$1,009.32
Bakersfield, CACalifornia—$1,018.49
Chico, CACalifornia—$1,006.17
El Centro, CACalifornia—$1,006.93
Fresno, CACalifornia—$1,006.17
Hanford, CACalifornia—$1,006.17

32651 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
32651 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 32651 in every payment locality

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.

How the rate is built · 32651

RVUs × geographic indexes × conversion factor

Office or facility?

Work18.31

18.31 RVUs× 1.000 GPCI

Practice expense8.27

8.27 RVUs× 1.000 GPCI

Malpractice4.55

4.55 RVUs× 1.000 GPCI

Adjusted RVUs

31.1300

Conversion factor

$33.4009

Medicare rate

$1,039.77

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,748

Code
32651
Physician work
18.31
Practice expense
8.27
Malpractice
4.55

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Facility calculation for 32651 in Delaware
ComponentRVULocality factorAdjusted
Physician work18.31× 1.00518.4015
Practice expense8.27× 0.9888.1708
Malpractice4.55× 0.8994.0904
Total RVUs30.6628
Conversion factor× 33.4009

Facility rate, Delaware$1024.16

Facility: (18.31 × 1.005 + 8.27 × 0.988 + 4.55 × 0.899) × $33.4009 = $1024.16

Open 32651 in the RVU calculator

Payment rules and modifiers for 32651

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

CMS payment indicators · 32651

Thoracoscopic decortication, partial decortication

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.76/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 32651

Thoracoscopic decortication, partial decortication

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

32651 without 50 · national facility

$1,039.77

Thoracoscopic decortication, partial decortication

32651-50 · Bilateral: 150%

$1,559.66

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 32651 has changed in Delaware

32651 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,024.16RVU26D
2026-07-01Not available in this setting$1,024.16RVU26C
2026-04-01Not available in this setting$1,024.16RVU26B
2026-01-01Not available in this setting$1,024.16RVU26A
2025-10-01Not available in this setting$1,049.46RVU25D
2025-07-01Not available in this setting$1,049.46RVU25C
2025-04-01Not available in this setting$1,049.46RVU25B
2025-01-01Not available in this setting$1,049.46RVU25A
2024-10-01Not available in this setting$1,074.96RVU24D
2024-07-01Not available in this setting$1,074.96RVU24C
2024-04-01Not available in this setting$1,074.96RVU24B
2024-03-09Not available in this setting$1,074.96RVU24AR
2024-01-01Not available in this setting$1,057.42RVU24A
2023-10-01Not available in this setting$1,090.06RVU23D
2023-07-01Not available in this setting$1,090.06RVU23C
2023-04-01Not available in this setting$1,090.06RVU23B
2023-01-01Not available in this setting$1,090.06RVU23A
2022-10-01Not available in this setting$1,113.51RVU22D
2022-07-01Not available in this setting$1,113.51RVU22C
2022-04-01Not available in this setting$1,113.51RVU22B
2022-01-01Not available in this setting$1,113.51RVU22A
2021-10-01Not available in this setting$1,116.79RVU21D
2021-07-01Not available in this setting$1,116.79RVU21C
2021-04-01Not available in this setting$1,116.79RVU21B
2021-01-01Not available in this setting$1,116.79RVU21A
2020-10-01Not available in this setting$1,155.63RVU20D
2020-07-01Not available in this setting$1,155.63RVU20C
2020-04-01Not available in this setting$1,155.63RVU20B
2020-01-01Not available in this setting$1,155.63RVU20A
2019-10-01Not available in this setting$1,167.96RVU19D
2019-07-01Not available in this setting$1,167.96RVU19C
2019-04-01Not available in this setting$1,167.96RVU19B
2019-01-01Not available in this setting$1,167.96RVU19A
2018-10-01Not available in this setting$1,166.97RVU18D
2018-07-01Not available in this setting$1,166.97RVU18C
2018-04-01Not available in this setting$1,166.97RVU18B
2018-01-01Not available in this setting$1,166.97RVU18AR1
2017-10-01Not available in this setting$1,167.79RVU17D
2017-07-01Not available in this setting$1,167.79RVU17C
2017-04-01Not available in this setting$1,167.79RVU17B
2017-01-01Not available in this setting$1,167.79RVU17A
2016-10-01Not available in this setting$1,170.71RVU16D
2016-07-01Not available in this setting$1,170.71RVU16C
2016-04-01Not available in this setting$1,170.71RVU16B
2016-01-01Not available in this setting$1,170.71RVU16A
2015-10-01Not available in this setting$1,175.64RVU15D
2015-07-01Not available in this setting$1,175.64RVU15C
2015-04-01Not available in this setting$1,169.79RVU15B
2015-01-01Not available in this setting$1,169.79RVU15A
2014-10-01Not available in this setting$1,134.28RVU14D
2014-07-01Not available in this setting$1,134.28RVU14C
2014-04-01Not available in this setting$1,134.28RVU14B
2014-01-01Not available in this setting$1,134.28RVU14A
2013-10-01Not available in this setting$1,089.35RVU13D
2013-07-01Not available in this setting$1,089.35RVU13C
2013-04-01Not available in this setting$1,089.35RVU13B
2013-01-01Not available in this setting$1,089.35RVU13AR

Price 32651 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

32651 billing questions

How do I distinguish 32651 from 32652?

Choose 32651 when the documented pulmonary decortication is partial. Use 32652 when the surgeon documents total decortication.

Is removal of loose fibrin reported with 32651?

Not when the work is limited to removing a foreign body or fibrin deposit rather than decorticating the lung. That procedure may fit 32653.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral decortication reported?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

What happens when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% 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
RVUs for 32651PPRRVU2026_Oct_nonQPP.csv, line 3,748 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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