CPT code 32668: Thoracoscopic wedge, each additional diagnostic resection2026 Medicare rate & RVUs in Arkansas
Reports each additional lung wedge resection performed for diagnostic sampling during thoracoscopy, beyond the initial resection, with a qualifying primary procedure.
In Arkansas, Medicare pays $127.35 for 32668 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 32668 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Arkansas compares for 32668
Across 109 of 109 payment localities, the facility rate for 32668 runs from $124.25 in Wisconsin to $181.22 in Alaska. Arkansas pays $127.35. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arkansas · this page$127.35
- Los Angeles, CA · California$141.38+$14.03
- Washington, DC area · District of Columbia$153.50+$26.15
- Miami, FL · Florida$180.04+$52.69
- Chicago, IL · Illinois$174.31+$46.96
- Manhattan, NY · New York$165.70+$38.35
- Alaska · Alaska$181.22+$53.87
Other areas in Arkansas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $128.91 |
| ArizonaArizona | — | $137.83 |
| Bakersfield, CACalifornia | — | $136.17 |
| Chico, CACalifornia | — | $134.20 |
| El Centro, CACalifornia | — | $134.32 |
| Fresno, CACalifornia | — | $134.20 |
| Hanford, CACalifornia | — | $134.20 |
| Madera, CACalifornia | — | $134.20 |
| Merced, CACalifornia | — | $134.20 |
| Modesto, CACalifornia | — | $134.20 |
| Napa, CACalifornia | — | $142.39 |
| Oxnard, CACalifornia | — | $139.09 |
| Redding, CACalifornia | — | $134.20 |
| Rest of CaliforniaCalifornia | — | $134.20 |
| Riverside, CACalifornia | — | $142.02 |
| Sacramento, CACalifornia | — | $137.38 |
| Salinas, CACalifornia | — | $136.81 |
| San Diego, CACalifornia | — | $137.58 |
| Marin County, CACalifornia | — | $146.14 |
| San Francisco, CACalifornia | — | $145.31 |
| San Benito County, CACalifornia | — | $150.12 |
| Santa Clara County, CACalifornia | — | $146.73 |
| San Luis Obispo, CACalifornia | — | $135.04 |
| Santa Cruz, CACalifornia | — | $136.93 |
| Santa Maria, CACalifornia | — | $136.65 |
| Santa Rosa, CACalifornia | — | $138.07 |
| Stockton, CACalifornia | — | $134.20 |
| Vallejo, CACalifornia | — | $141.19 |
| Visalia, CACalifornia | — | $134.20 |
| Yuba City, CACalifornia | — | $134.20 |
| ColoradoColorado | — | $139.05 |
| ConnecticutConnecticut | — | $150.55 |
| DelawareDelaware | — | $139.74 |
| Fort Lauderdale, FLFlorida | — | $161.91 |
| Rest of FloridaFlorida | — | $153.35 |
| Atlanta, GAGeorgia | — | $147.46 |
| Rest of GeorgiaGeorgia | — | $144.51 |
| Hawaii, Guam, HIHawaii | — | $134.39 |
| IowaIowa | — | $125.58 |
| IdahoIdaho | — | $127.53 |
| East St. Louis, ILIllinois | — | $165.10 |
| Rest of IllinoisIllinois | — | $153.97 |
| Suburban Chicago, ILIllinois | — | $161.99 |
| IndianaIndiana | — | $127.98 |
| KansasKansas | — | $127.97 |
| KentuckyKentucky | — | $137.69 |
| New Orleans, LALouisiana | — | $144.11 |
| Rest of LouisianaLouisiana | — | $138.66 |
| Metropolitan Boston, MAMassachusetts | — | $147.11 |
| Rest of MassachusettsMassachusetts | — | $139.61 |
| Baltimore area, MDMaryland | — | $150.74 |
| Rest of MarylandMaryland | — | $141.17 |
| Rest of MaineMaine | — | $131.16 |
| Southern Maine, MEMaine | — | $132.78 |
| Detroit, MIMichigan | — | $157.99 |
| Rest of MichiganMichigan | — | $143.38 |
| MinnesotaMinnesota | — | $125.36 |
| Metropolitan Kansas City, MOMissouri | — | $140.19 |
| Metropolitan St. Louis, MOMissouri | — | $141.06 |
| Rest of MissouriMissouri | — | $138.60 |
| MississippiMississippi | — | $132.85 |
| MontanaMontana | — | $141.91 |
| North CarolinaNorth Carolina | — | $131.83 |
| North DakotaNorth Dakota | — | $127.47 |
| NebraskaNebraska | — | $125.27 |
| New HampshireNew Hampshire | — | $139.71 |
| Northern New JerseyNew Jersey | — | $152.93 |
| Rest of New JerseyNew Jersey | — | $150.05 |
| New MexicoNew Mexico | — | $145.22 |
| NevadaNevada | — | $137.90 |
| NYC suburbs and Long Island, NYNew York | — | $172.84 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $153.35 |
| Queens, NYNew York | — | $162.58 |
| Rest of New YorkNew York | — | $133.73 |
| OhioOhio | — | $140.43 |
| OklahomaOklahoma | — | $134.41 |
| Portland, OROregon | — | $139.47 |
| Rest of OregonOregon | — | $134.63 |
| Metropolitan Philadelphia, PAPennsylvania | — | $149.23 |
| Rest of PennsylvaniaPennsylvania | — | $139.00 |
| Puerto RicoPuerto Rico | — | $141.80 |
| Rhode IslandRhode Island | — | $141.83 |
| South CarolinaSouth Carolina | — | $136.80 |
| South DakotaSouth Dakota | — | $125.76 |
| TennesseeTennessee | — | $128.87 |
| Austin, TXTexas | — | $140.51 |
| Beaumont, TXTexas | — | $138.45 |
| Brazoria, TXTexas | — | $137.20 |
| Dallas, TXTexas | — | $139.29 |
| Fort Worth, TXTexas | — | $139.41 |
| Galveston, TXTexas | — | $138.40 |
| Houston, TXTexas | — | $151.77 |
| Rest of TexasTexas | — | $138.58 |
| UtahUtah | — | $138.28 |
| VirginiaVirginia | — | $134.45 |
| Virgin Islands, VIUnited States Virgin Islands | — | $141.80 |
| VermontVermont | — | $129.71 |
| Rest of WashingtonWashington | — | $138.44 |
| King County, WAWashington | — | $146.86 |
| WisconsinWisconsin | — | $124.25 |
| West VirginiaWest Virginia | — | $149.88 |
| WyomingWyoming | — | $135.61 |
32668 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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact Arkansas inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,764
- Code
- 32668
- Physician work
- 2.93
- Practice expense
- 0.59
- Malpractice
- 0.73
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.000 | 2.9300 |
| Practice expense | 0.59 | × 0.859 | 0.5068 |
| Malpractice | 0.73 | × 0.515 | 0.3760 |
| Total RVUs | 3.8128 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$127.35
Facility: (2.93 × 1 + 0.59 × 0.859 + 0.73 × 0.515) × $33.4009 = $127.35
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
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.
How 32668 has changed in Arkansas
32668 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $127.35 | RVU26D |
| 2026-07-01 | Not available in this setting | $127.35 | RVU26C |
| 2026-04-01 | Not available in this setting | $127.35 | RVU26B |
| 2026-01-01 | Not available in this setting | $127.35 | RVU26A |
| 2025-10-01 | Not available in this setting | $133.31 | RVU25D |
| 2025-07-01 | Not available in this setting | $133.31 | RVU25C |
| 2025-04-01 | Not available in this setting | $133.31 | RVU25B |
| 2025-01-01 | Not available in this setting | $133.31 | RVU25A |
| 2024-10-01 | Not available in this setting | $136.96 | RVU24D |
| 2024-07-01 | Not available in this setting | $136.96 | RVU24C |
| 2024-04-01 | Not available in this setting | $136.96 | RVU24B |
| 2024-03-09 | Not available in this setting | $136.96 | RVU24AR |
| 2024-01-01 | Not available in this setting | $134.72 | RVU24A |
| 2023-10-01 | Not available in this setting | $138.52 | RVU23D |
| 2023-07-01 | Not available in this setting | $138.52 | RVU23C |
| 2023-04-01 | Not available in this setting | $138.52 | RVU23B |
| 2023-01-01 | Not available in this setting | $138.52 | RVU23A |
| 2022-10-01 | Not available in this setting | $141.36 | RVU22D |
| 2022-07-01 | Not available in this setting | $141.36 | RVU22C |
| 2022-04-01 | Not available in this setting | $141.36 | RVU22B |
| 2022-01-01 | Not available in this setting | $141.36 | RVU22A |
| 2021-10-01 | Not available in this setting | $142.18 | RVU21D |
| 2021-07-01 | Not available in this setting | $142.18 | RVU21C |
| 2021-04-01 | Not available in this setting | $142.18 | RVU21B |
| 2021-01-01 | Not available in this setting | $142.18 | RVU21A |
| 2020-10-01 | Not available in this setting | $147.65 | RVU20D |
| 2020-07-01 | Not available in this setting | $147.65 | RVU20C |
| 2020-04-01 | Not available in this setting | $147.65 | RVU20B |
| 2020-01-01 | Not available in this setting | $147.65 | RVU20A |
| 2019-10-01 | Not available in this setting | $149.15 | RVU19D |
| 2019-07-01 | Not available in this setting | $149.15 | RVU19C |
| 2019-04-01 | Not available in this setting | $149.15 | RVU19B |
| 2019-01-01 | Not available in this setting | $149.15 | RVU19A |
| 2018-10-01 | Not available in this setting | $148.99 | RVU18D |
| 2018-07-01 | Not available in this setting | $148.99 | RVU18C |
| 2018-04-01 | Not available in this setting | $148.99 | RVU18B |
| 2018-01-01 | Not available in this setting | $148.99 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $148.57 | RVU17D |
| 2017-07-01 | Not available in this setting | $148.57 | RVU17C |
| 2017-04-01 | Not available in this setting | $148.57 | RVU17B |
| 2017-01-01 | Not available in this setting | $148.57 | RVU17A |
| 2016-10-01 | Not available in this setting | $147.80 | RVU16D |
| 2016-07-01 | Not available in this setting | $147.80 | RVU16C |
| 2016-04-01 | Not available in this setting | $147.80 | RVU16B |
| 2016-01-01 | Not available in this setting | $147.80 | RVU16A |
| 2015-10-01 | Not available in this setting | $148.65 | RVU15D |
| 2015-07-01 | Not available in this setting | $148.65 | RVU15C |
| 2015-04-01 | Not available in this setting | $147.91 | RVU15B |
| 2015-01-01 | Not available in this setting | $147.91 | RVU15A |
| 2014-10-01 | Not available in this setting | $147.11 | RVU14D |
| 2014-07-01 | Not available in this setting | $147.11 | RVU14C |
| 2014-04-01 | Not available in this setting | $147.11 | RVU14B |
| 2014-01-01 | Not available in this setting | $147.11 | RVU14A |
| 2013-10-01 | Not available in this setting | $149.15 | RVU13D |
| 2013-07-01 | Not available in this setting | $149.15 | RVU13C |
| 2013-04-01 | Not available in this setting | $149.15 | RVU13B |
| 2013-01-01 | Not available in this setting | $149.15 | RVU13AR |
Where the Arkansas rate applies
Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.
- Acorn
- Adona
- Alexander
- Alicia
- Alix
- Alleene
- Allport
- Alma
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
Fee sheets
Put 32668 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet