CPT code 32653: Thoracoscopy removal, foreign body or fibrin2026 Medicare rate & RVUs in California
Reports thoracoscopic removal of a foreign object or fibrin deposit from the pleural space during an operative chest procedure.
CMS doesn’t publish an office rate for 32653 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 32653 covers
A thoracic surgeon uses a thoracoscope to remove a foreign object or fibrinous material from the pleural space. The work is performed in an operating room, commonly during surgery for a retained intrathoracic object or fibrin deposit requiring operative removal. The operative report should identify the material and its location and describe its removal through the thoracoscopic approach.
Report this code when removal of the foreign body or fibrin deposit is the operative service, rather than pleural decortication or removal of an object from the pericardial sac. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. An assistant at surgery may be paid; co-surgeons require 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 32653 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $988.60 |
| Chico, CA | Unavailable | $977.10 |
| El Centro, CA | Unavailable | $977.81 |
| Fresno, CA | Unavailable | $977.10 |
| Hanford, CA | Unavailable | $977.10 |
| Los Angeles, CA | Unavailable | $1,033.16 |
| Madera, CA | Unavailable | $977.10 |
| Marin County, CA | Unavailable | $1,098.18 |
| Merced, CA | Unavailable | $977.10 |
| Modesto, CA | Unavailable | $977.10 |
| Napa, CA | Unavailable | $1,061.03 |
| Oxnard, CA | Unavailable | $1,019.40 |
| Redding, CA | Unavailable | $977.10 |
| Rest of California | Unavailable | $977.10 |
| Riverside, CA | Unavailable | $1,022.48 |
| Sacramento, CA | Unavailable | $1,006.65 |
| Salinas, CA | Unavailable | $1,002.60 |
| San Benito County, CA | Unavailable | $1,126.68 |
| San Diego, CA | Unavailable | $1,012.97 |
| San Francisco, CA | Unavailable | $1,093.38 |
| San Luis Obispo, CA | Unavailable | $988.85 |
| Santa Clara County, CA | Unavailable | $1,107.04 |
| Santa Cruz, CA | Unavailable | $1,011.98 |
| Santa Maria, CA | Unavailable | $1,002.74 |
| Santa Rosa, CA | Unavailable | $1,020.86 |
| Stockton, CA | Unavailable | $977.10 |
| Vallejo, CA | Unavailable | $1,054.10 |
| Visalia, CA | Unavailable | $977.10 |
| Yuba City, CA | Unavailable | $977.10 |
How the 32653 rate is calculated
Each of 32653’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 · 32653
RVUs × geographic indexes × conversion factor
Work17.72
17.72 RVUs× 1.000 GPCI
Practice expense8.18
8.18 RVUs× 1.000 GPCI
Malpractice4.23
4.23 RVUs× 1.000 GPCI
Adjusted RVUs
30.1300
Conversion factor
$33.4009
Medicare rate
$1,006.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32653
32653 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32653
Thoracoscopy removal, foreign body or fibrin
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 32653
Thoracoscopy removal, foreign body or fibrin
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
32653 without 51 · national facility
$1,006.37
Thoracoscopy removal, foreign body or fibrin
32653-51 · Second procedure: 50%
$503.19
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%).
32653 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 32651Thoracoscopic decorticationPartial decortication
- 32651 describes partial decortication. Choose 32653 when the operative service is removal of a foreign body or fibrin deposit, not decortication.
- 32652Thoracoscopic decorticationTotal pulmonary decortication
- 32652 describes total decortication. The operative goal and extent of decortication distinguish it from removal reported with 32653.
- 32658ThoracoscopyPericardial foreign body removal
- 32658 is for removing a foreign body from the pericardial sac; 32653 is used for the corresponding removal service in the pleural space.
32653 billing questions
How is this different from thoracoscopic decortication?
Use 32653 for removal of a foreign body or fibrin deposit. Codes 32651 and 32652 describe partial and total lung decortication, respectively; select based on the operation documented.
When is 32658 the better code?
32658 is for thoracoscopic removal of a foreign body from the pericardial sac. Use 32653 for the removal service involving the pleural space.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor or anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard 50% multiple-procedure reduction to the other procedures.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons require supporting documentation, while team surgery is not permitted.
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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