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CPT code 32668: Thoracoscopic wedge, each additional diagnostic resection2026 Medicare rate & RVUs

Reports each additional lung wedge resection performed for diagnostic sampling during thoracoscopy, beyond the initial resection, with a qualifying primary procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.9K Medicare services in 2024

Medicare pays $141.95 for 32668 nationally in a facility.

Medicare rate · 32668

Thoracoscopic wedge, each additional diagnostic resection

Office or facility?

Work RVUs
2.93
Total RVUs
4.25
Global days
ZZZ

National rate · 2026

$141.95

Facility setting, before claim adjustments.

See every locality for 32668 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 32668 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 32668 covers

A thoracic surgeon uses thoracoscopy to remove an additional wedge-shaped portion of lung for diagnostic examination, often when more than one nodule or area requires tissue sampling. The specimen is submitted for pathology. This code describes an additional diagnostic resection, not the initial wedge or a wedge performed therapeutically to remove a lesion. The service is typically performed in an operating room with the patient under anesthesia.

Report this add-on code only with a qualifying primary thoracoscopic procedure; it is commonly paired with diagnostic thoracoscopy for biopsy of a lung nodule or mass, such as 32608. The operative report should establish that an additional diagnostic wedge was actually resected, rather than simply biopsied or included in a therapeutic wedge procedure. CMS treats payment as part of the primary procedure’s global period, so this code is paid only when reported with the primary procedure and within that global period.

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 32668 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

32668 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$128.91
AlaskaUnavailable$181.22
ArizonaUnavailable$137.83
ArkansasUnavailable$127.35
Atlanta, GAUnavailable$147.46
Austin, TXUnavailable$140.51
Bakersfield, CAUnavailable$136.17
Baltimore area, MDUnavailable$150.74
Beaumont, TXUnavailable$138.45
Brazoria, TXUnavailable$137.20

32668 rates by state

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

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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
32668 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

How the 32668 rate is calculated

Each of 32668’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 · 32668

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.93

2.93 RVUs× 1.000 GPCI

Practice expense0.59

0.59 RVUs× 1.000 GPCI

Malpractice0.73

0.73 RVUs× 1.000 GPCI

Adjusted RVUs

4.2500

Conversion factor

$33.4009

Medicare rate

$141.95

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

Payment rules and modifiers for 32668

The CMS indicators that decide how 32668 is paid alongside other services.

CMS payment indicators · 32668

Thoracoscopic wedge, each additional diagnostic resection

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

32668 without 80 · national facility

$141.95

Thoracoscopic wedge, each additional diagnostic resection

32668-80 · Assistant: 16%

$22.71

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

32668 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 32668

    Thoracoscopic wedge, each additional diagnostic resection2.93 wRVU

    Not priced

  • 32608

    Thoracoscopic biopsy, pulmonary nodule or mass6.67 wRVU

    Not priced

  • 32667

    Lung wedge resection, each additional resection2.93 wRVU

    Not priced

  • 32666

    Lung wedge resection, therapeutic, initial resection14.14 wRVU

    Not priced

How to choose

32608Thoracoscopic biopsyPulmonary nodule or mass
32608 reports the primary thoracoscopic biopsy of a lung nodule or mass. 32668 reports each additional diagnostic lung wedge resection with a qualifying primary procedure.
32667Lung wedge resectionEach additional resection
32667 is for each additional therapeutic wedge resection; 32668 is for an additional wedge resection performed for diagnostic sampling.
32666Lung wedge resectionTherapeutic, initial resection
32666 reports the initial therapeutic wedge resection and includes diagnostic wedge resection when performed. 32668 applies to an additional diagnostic wedge, not the therapeutic resection itself.

Codes related to 32668

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

Codes related to 32668
CodeHow it relatesNational office range
Add-on codes
32608Thoracoscopic biopsy, pulmonary nodule or massCommon primary thoracoscopic service for diagnostic sampling of a lung nodule or mass.No office rate
Used instead
32666Lung wedge resection, therapeutic, initial resectionInitial therapeutic wedge resection; includes diagnostic wedge resection when performed.No office rate
32669Lung resection, anatomic segmentectomyThoracoscopic segmentectomy removes a lung segment rather than an additional diagnostic wedge.No office rate
Same family
32667Lung wedge resection, each additional resectionAdd-on for each additional therapeutic wedge resection.No office rate

32668 billing questions

When should 32668 be reported instead of 32608?

Use 32608 for the primary thoracoscopic biopsy of a lung nodule or mass. Report 32668 for each additional diagnostic lung wedge resection when the primary procedure and documentation support the add-on service.

Can 32668 be billed by itself?

No. CMS identifies it as an add-on code, so it must be reported with a primary procedure and is paid within that procedure’s global period.

How does 32668 differ from 32667?

32668 describes an additional wedge resection for diagnostic sampling. 32667 describes each additional therapeutic wedge resection.

Does a diagnostic wedge performed during therapeutic resection support 32668?

A diagnostic wedge included with a therapeutic wedge procedure is not separately reported as an additional diagnostic resection. The operative report should distinguish a separately performed additional diagnostic wedge from tissue removed as part of therapeutic resection.

What documentation supports reporting an additional unit?

Document the additional diagnostic wedge resection, the lung site or lesion sampled, and the reason for obtaining the additional specimen. The record should distinguish it from the initial biopsy or wedge and from a therapeutic resection.

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 32668PPRRVU2026_Oct_nonQPP.csv, line 3,764 (RVU26D)

Open CMS sourceHow we calculate rates

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