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CPT code 32674: Node dissection, mediastinal and regional nodes2026 Medicare rate & RVUs

Reports thoracoscopic mediastinal and regional lymph node dissection performed with a qualifying lung resection, commonly for oncologic staging.

CMS RVU26DEffective Oct 1, 2026109 payment localities21.9K Medicare services in 2024

Medicare pays $195.40 for 32674 nationally in a facility.

Medicare rate · 32674

Node dissection, mediastinal and regional nodes

Office or facility?

Work RVUs
4.02
Total RVUs
5.85
Global days
ZZZ

National rate · 2026

$195.40

Facility setting, before claim adjustments.

See every locality for 32674 →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 32674 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 32674 covers

This add-on represents thoracoscopic removal of mediastinal and regional lymph nodes, often performed by a thoracic surgeon during resection of a lung malignancy for nodal staging. The surgeon identifies and removes lymphatic tissue from the relevant mediastinal and regional areas through the thoracoscopic approach. The service is typically performed in the operating room as part of a lung resection, rather than as a stand-alone procedure.

Report 32674 with an eligible primary thoracoscopic resection, such as lobectomy, segmentectomy, bilobectomy, or pneumonectomy, when the lymph node dissection is performed. The operative report should support that nodal dissection occurred and describe the relevant nodal areas addressed; a lung resection alone does not establish that this additional service was performed. CMS treats 32674 as an add-on code: it is billed only with a primary procedure, and its payment is included within that procedure’s 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 32674 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

32674 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$177.23
AlaskaUnavailable$248.99
ArizonaUnavailable$189.65
ArkansasUnavailable$175.06
Atlanta, GAUnavailable$203.08
Austin, TXUnavailable$193.35
Bakersfield, CAUnavailable$187.22
Baltimore area, MDUnavailable$207.59
Beaumont, TXUnavailable$190.54
Brazoria, TXUnavailable$188.73

32674 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
32674 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 32674 rate is calculated

Each of 32674’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 · 32674

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.02

4.02 RVUs× 1.000 GPCI

Practice expense0.81

0.81 RVUs× 1.000 GPCI

Malpractice1.02

1.02 RVUs× 1.000 GPCI

Adjusted RVUs

5.8500

Conversion factor

$33.4009

Medicare rate

$195.40

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

Payment rules and modifiers for 32674

The CMS indicators that decide how 32674 is paid alongside other services.

CMS payment indicators · 32674

Node dissection, mediastinal and regional nodes

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

32674 without 80 · national facility

$195.40

Node dissection, mediastinal and regional nodes

32674-80 · Assistant: 16%

$31.26

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

When to use modifier 80

32674 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 32674

    Node dissection, mediastinal and regional nodes4.02 wRVU

    Not priced

  • 32662

    Mediastinal excision, thoracoscopic cyst, tumor, or mass14.62 wRVU

    Not priced

  • 32663

    Thoracoscopic lobectomy, single pulmonary lobe24.02 wRVU

    Not priced

  • 32669

    Lung resection, anatomic segmentectomy22.94 wRVU

    Not priced

  • 32668

    Thoracoscopic wedge, each additional diagnostic resection2.93 wRVU

    Not priced

How to choose

32662Mediastinal excisionThoracoscopic cyst, tumor, or mass
32662 reports thoracoscopic excision of a mediastinal lesion. Use 32674 for lymph node dissection performed with a qualifying primary procedure.
32663Thoracoscopic lobectomySingle pulmonary lobe
32663 reports the thoracoscopic lobectomy. Add 32674 only when mediastinal and regional lymph node dissection is also performed.
32669Lung resectionAnatomic segmentectomy
32669 reports thoracoscopic segmentectomy. It is the primary resection code; 32674 represents accompanying lymph node dissection.
32668Thoracoscopic wedgeEach additional diagnostic resection
32668 reports a thoracoscopic diagnostic wedge resection. 32674 instead captures lymph node dissection with a qualifying primary procedure.

Codes related to 32674

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

Codes related to 32674
CodeHow it relatesNational office range
Primary code
32663Thoracoscopic lobectomy, single pulmonary lobeThoracoscopic lobectomy may be the primary procedure when lymph node dissection is also performed.No office rate
32669Lung resection, anatomic segmentectomyThoracoscopic segmentectomy may be the primary procedure for the accompanying node dissection.No office rate
32670Thoracoscopic lung resection, two lobes removedThoracoscopic bilobectomy may be the primary procedure when nodal dissection is performed.No office rate
32671Pneumonectomy, thoracoscopic approachThoracoscopic pneumonectomy may be the primary procedure when nodal dissection is performed.No office rate

32674 billing questions

Can 32674 be reported by itself?

No. It is an add-on code and must be billed with a qualifying primary procedure, such as a thoracoscopic lobectomy or segmentectomy.

Which primary procedures are commonly paired with 32674?

It is commonly reported with thoracoscopic lobectomy, segmentectomy, bilobectomy, or pneumonectomy when mediastinal and regional lymph node dissection is also performed.

Does the lung resection alone support reporting 32674?

No. The operative documentation should support that lymph node dissection was performed, with the relevant nodal areas addressed.

How does 32674 differ from 32662?

32674 reports lymph node dissection performed with a primary thoracoscopic procedure. 32662 describes thoracoscopic excision of a mediastinal lesion, not lymphadenectomy.

Does 32674 have a separate global period?

CMS payment for this add-on is within the global period of the primary procedure with which it is billed.

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 32674PPRRVU2026_Oct_nonQPP.csv, line 3,771 (RVU26D)

Open CMS sourceHow we calculate rates

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