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CPT code 32820: Chest wall reconstruction, major reconstruction2026 Medicare rate & RVUs

Report major reconstruction to restore chest-wall structure after substantial injury-related damage, rather than for a limited fistula closure or focal lung hernia repair.

CMS RVU26DEffective Oct 1, 2026109 payment localities127 Medicare services in 2024

Medicare pays $1,313.99 for 32820 nationally in a facility.

Medicare rate · 32820

Chest wall reconstruction, major reconstruction

Office or facility?

Work RVUs
21.95
Total RVUs
39.34
Global days
090

National rate · 2026

$1,313.99

Facility setting, before claim adjustments.

See every locality for 32820 →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 32820 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 32820 covers

This service rebuilds a substantially damaged chest wall, commonly after trauma that has left a large defect or disrupted the chest wall’s structural support. A thoracic surgeon typically performs the reconstruction in an operating room, restoring support and coverage; the repair may involve graft or prosthetic material. The work is more extensive than closing a drainage site or repairing a focal lung hernia.

Select the code when the operative report supports major reconstruction, describing the injury, defect, structures rebuilt, and materials used. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Modifier 50 is inappropriate. An assistant at surgery 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.

Where 32820 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

32820 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,184.72
AlaskaUnavailable$1,624.07
ArizonaUnavailable$1,275.26
ArkansasUnavailable$1,169.01
Atlanta, GAUnavailable$1,359.41
Austin, TXUnavailable$1,317.61
Bakersfield, CAUnavailable$1,294.38
Baltimore area, MDUnavailable$1,398.20
Beaumont, TXUnavailable$1,265.20
Brazoria, TXUnavailable$1,275.94

32820 rates by state

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

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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
32820 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 32820 rate is calculated

Each of 32820’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 · 32820

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.95

21.95 RVUs× 1.000 GPCI

Practice expense11.90

11.90 RVUs× 1.000 GPCI

Malpractice5.49

5.49 RVUs× 1.000 GPCI

Adjusted RVUs

39.3400

Conversion factor

$33.4009

Medicare rate

$1,313.99

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

Payment rules and modifiers for 32820

32820 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32820

Chest wall reconstruction, major reconstruction

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)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.
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 · 32820

Chest wall reconstruction, major reconstruction

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 51 · payment effect

With and without the modifier

32820 without 51 · national facility

$1,313.99

Chest wall reconstruction, major reconstruction

32820-51 · Second procedure: 50%

$657.00

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%).

When to use modifier 51

32820 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 32820

    Chest wall reconstruction, major reconstruction21.95 wRVU

    Not priced

  • 32800

    Lung hernia repair15.32 wRVU

    Not priced

  • 32810

    Chest closure, after drainage or thoracic procedure14.58 wRVU

    Not priced

  • 32815

    Fistula closure, bronchial fistula48.78 wRVU

    Not priced

How to choose

32800Lung hernia repair
32800 addresses a lung hernia protruding through the chest wall. Use 32820 when the operative work is major reconstruction of the chest wall itself.
32810Chest closureAfter drainage or thoracic procedure
32810 is for closing the chest wall after drainage. It does not describe major reconstruction of a substantially damaged chest wall.
32815Fistula closureBronchial fistula
32815 addresses closure of a bronchial fistula. Choose 32820 when the principal work is rebuilding the chest wall rather than closing the fistula.

Codes related to 32820

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

Codes related to 32820
CodeHow it relatesNational office range
Used instead
32800Lung hernia repairFor repair of a focal lung hernia through the chest wall rather than major chest-wall reconstruction.No office rate
32810Chest closure, after drainage or thoracic procedureFor chest-wall closure after drainage when major reconstruction is not the service performed.No office rate
32815Fistula closure, bronchial fistulaFor closure of a bronchial fistula rather than reconstruction of a major chest-wall defect.No office rate
Often billed with
15734Trunk flap, muscle, skin, or fascia flapMay accompany reconstruction when a separately performed trunk muscle or myocutaneous flap provides coverage.No office rate

32820 billing questions

When is this more appropriate than a limited chest-wall repair?

Use 32820 for major reconstruction of a substantial chest-wall defect, such as injury-related structural damage. A focal lung hernia repair or closure after drainage has a more specific code.

What documentation supports reporting 32820?

The operative report should establish the cause and extent of the defect, identify the chest-wall structures reconstructed, and describe the reconstructive work and materials used.

Should modifier 50 be appended for reconstruction on both sides?

No. Modifier 50 is inappropriate for this service.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

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

What postoperative care is included?

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

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 32820PPRRVU2026_Oct_nonQPP.csv, line 3,788 (RVU26D)

Open CMS sourceHow we calculate rates

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