CPT code 32994: Lung tumor ablation, percutaneous cryoablation2026 Medicare rate & RVUs
Report percutaneous cryoablation to reduce or eradicate one or more pulmonary tumors, including involved pleura or chest wall, with imaging guidance.
Medicare pays $4,544.53 for 32994 nationally in the office and $380.77 in a hospital or facility. Local office rates run $3,933.70–$6,425.36.
Medicare rate · 32994
Lung tumor ablation, percutaneous cryoablation
- Work RVUs
- 8.8
- Total RVUs
- 136.06
- Global days
- 000
National rate · 2026
$4,544.53
Office setting, before claim adjustments.
See every locality for 32994 →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.
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On this page 10 sections
What 32994 covers
This service uses image-guided probes inserted through the skin to freeze and destroy one or more pulmonary tumors. It may include tumors involving the pleura or chest wall. Interventional radiologists commonly perform it in a hospital or other facility setting, often using CT to guide probe placement and monitor treatment. The code identifies cryoablation, not radiofrequency or microwave ablation.
Report the code when the documented treatment is percutaneous cryoablation; the code includes imaging guidance and covers one or more tumors. The record should support the tumor site, percutaneous approach, cryoablation method, and image-guided treatment. It has a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, Medicare pays the highest-valued procedure in full and other procedures at 50%. For bilateral reporting with modifier 50, payment is 150%. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are 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 32994 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$3933.70 to $6425.36
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $4,002.88 | $359.59 |
| Alaska | $4,950.61 | $516.21 |
| Arizona | $4,408.98 | $374.30 |
| Arkansas | $3,933.70 | $357.04 |
| Atlanta, GA | $4,619.60 | $389.22 |
| Austin, TX | $4,785.90 | $380.65 |
| Bakersfield, CA | $4,941.90 | $378.43 |
| Baltimore area, MD | $4,865.00 | $397.29 |
| Beaumont, TX | $4,162.61 | $373.59 |
| Brazoria, TX | $4,501.57 | $375.29 |
| Chicago, IL | $4,610.92 | $426.35 |
| Chico, CA | $4,938.88 | $375.40 |
| Colorado | $4,810.64 | $380.40 |
| Connecticut | $4,882.14 | $397.78 |
| Dallas, TX | $4,525.56 | $378.46 |
| Delaware | $4,492.02 | $378.23 |
| Detroit, MI | $4,419.84 | $401.81 |
| East St. Louis, IL | $4,241.02 | $410.36 |
| El Centro, CA | $4,939.04 | $375.57 |
| Fort Lauderdale, FL | $4,626.34 | $408.45 |
| Fort Worth, TX | $4,483.82 | $378.36 |
| Fresno, CA | $4,938.88 | $375.40 |
| Galveston, TX | $4,511.61 | $377.00 |
| Hanford, CA | $4,938.88 | $375.40 |
| Hawaii, Guam, HI | $5,108.22 | $374.03 |
| Houston, TX | $4,529.92 | $395.31 |
| Idaho | $4,189.55 | $358.89 |
| Indiana | $4,219.50 | $359.70 |
| Iowa | $4,165.92 | $356.09 |
| Kansas | $4,123.11 | $359.07 |
| Kentucky | $4,073.58 | $372.00 |
| King County, WA | $5,510.41 | $401.49 |
| Los Angeles, CA | $5,317.10 | $391.38 |
| Madera, CA | $4,938.88 | $375.40 |
| Manhattan, NY | $5,266.10 | $427.81 |
| Marin County, CA | $6,283.43 | $412.53 |
| Merced, CA | $4,938.88 | $375.40 |
| Metropolitan Boston, MA | $5,371.04 | $399.51 |
| Metropolitan Kansas City, MO | $4,286.51 | $376.74 |
| Metropolitan Philadelphia, PA | $4,729.17 | $394.70 |
| Metropolitan St. Louis, MO | $4,342.17 | $378.27 |
| Miami, FL | $4,768.50 | $434.03 |
| Minnesota | $4,643.31 | $358.81 |
| Mississippi | $3,949.62 | $364.62 |
| Modesto, CA | $4,938.88 | $375.40 |
| Montana | $4,544.46 | $380.70 |
| Napa, CA | $5,887.68 | $399.85 |
| Nebraska | $4,199.03 | $355.88 |
| Nevada | $4,543.17 | $375.25 |
| New Hampshire | $4,713.26 | $378.79 |
| New Mexico | $4,201.21 | $383.05 |
| New Orleans, LA | $4,300.25 | $382.16 |
| North Carolina | $4,249.92 | $365.13 |
| North Dakota | $4,524.69 | $360.93 |
| Northern New Jersey | $5,240.07 | $410.11 |
| NYC suburbs and Long Island, NY | $5,389.01 | $438.31 |
| Ohio | $4,177.90 | $376.39 |
| Oklahoma | $4,085.84 | $367.60 |
| Oxnard, CA | $5,307.69 | $386.13 |
| Portland, OR | $5,008.79 | $382.85 |
| Poughkeepsie and northern NYC suburbs, NY | $4,965.40 | $406.09 |
| Puerto Rico | $4,590.41 | $380.86 |
| Queens, NY | $5,345.63 | $424.07 |
| Redding, CA | $4,938.88 | $375.40 |
| Rest of California | $4,938.88 | $375.40 |
| Rest of Florida | $4,375.77 | $395.22 |
| Rest of Georgia | $4,095.48 | $381.41 |
| Rest of Illinois | $4,196.43 | $394.93 |
| Rest of Louisiana | $4,058.15 | $373.22 |
| Rest of Maine | $4,194.53 | $363.87 |
| Rest of Maryland | $4,595.33 | $381.61 |
| Rest of Massachusetts | $4,765.96 | $381.53 |
| Rest of Michigan | $4,181.94 | $380.43 |
| Rest of Missouri | $3,961.68 | $372.53 |
| Rest of New Jersey | $4,947.51 | $400.68 |
| Rest of New York | $4,323.75 | $368.18 |
| Rest of Oregon | $4,517.74 | $370.64 |
| Rest of Pennsylvania | $4,196.88 | $374.55 |
| Rest of Texas | $4,326.21 | $374.80 |
| Rest of Washington | $4,763.88 | $379.44 |
| Rhode Island | $4,685.67 | $384.51 |
| Riverside, CA | $4,949.76 | $386.28 |
| Sacramento, CA | $5,227.01 | $384.56 |
| Salinas, CA | $5,208.67 | $382.88 |
| San Benito County, CA | $6,425.36 | $421.23 |
| San Diego, CA | $5,364.62 | $384.77 |
| San Francisco, CA | $6,282.30 | $411.40 |
| San Luis Obispo, CA | $5,120.22 | $377.70 |
| Santa Clara County, CA | $6,420.72 | $416.58 |
| Santa Cruz, CA | $5,441.90 | $382.93 |
| Santa Maria, CA | $5,237.31 | $382.37 |
| Santa Rosa, CA | $5,499.37 | $386.27 |
| South Carolina | $4,219.01 | $371.70 |
| South Dakota | $4,522.35 | $358.59 |
| Southern Maine, ME | $4,494.25 | $367.96 |
| Stockton, CA | $4,938.88 | $375.40 |
| Suburban Chicago, IL | $4,686.23 | $410.06 |
| Tennessee | $4,145.30 | $360.44 |
| Utah | $4,288.09 | $374.16 |
| Vallejo, CA | $5,886.04 | $398.21 |
| Vermont | $4,485.85 | $363.74 |
| Virgin Islands, VI | $4,590.41 | $380.86 |
| Virginia | $4,463.01 | $370.04 |
| Visalia, CA | $4,938.88 | $375.40 |
| Washington, DC area | $5,314.83 | $409.93 |
| West Virginia | $4,006.47 | $388.17 |
| Wisconsin | $4,344.29 | $355.41 |
| Wyoming | $4,535.84 | $372.09 |
| Yuba City, CA | $4,938.88 | $375.40 |
32994 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.
$3,933.70
$5,682.12
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $4,950.61 | 1 |
| AL | $4,002.88 | 1 |
| AR | $3,933.70 | 1 |
| AZ | $4,408.98 | 1 |
| CA | $4,938.88–$6,425.36 | 29 |
| CO | $4,810.64 | 1 |
| CT | $4,882.14 | 1 |
| DC | $5,314.83 | 1 |
| DE | $4,492.02 | 1 |
| FL | $4,375.77–$4,768.50 | 3 |
| GA | $4,095.48–$4,619.60 | 2 |
| GU | $5,108.22 | 1 |
| HI | $5,108.22 | 1 |
| IA | $4,165.92 | 1 |
| ID | $4,189.55 | 1 |
| IL | $4,196.43–$4,686.23 | 4 |
| IN | $4,219.50 | 1 |
| KS | $4,123.11 | 1 |
| KY | $4,073.58 | 1 |
| LA | $4,058.15–$4,300.25 | 2 |
| MA | $4,765.96–$5,371.04 | 2 |
| MD | $4,595.33–$5,314.83 | 3 |
| ME | $4,194.53–$4,494.25 | 2 |
| MI | $4,181.94–$4,419.84 | 2 |
| MN | $4,643.31 | 1 |
| MO | $3,961.68–$4,342.17 | 3 |
| MS | $3,949.62 | 1 |
| MT | $4,544.46 | 1 |
| NC | $4,249.92 | 1 |
| ND | $4,524.69 | 1 |
| NE | $4,199.03 | 1 |
| NH | $4,713.26 | 1 |
| NJ | $4,947.51–$5,240.07 | 2 |
| NM | $4,201.21 | 1 |
| NV | $4,543.17 | 1 |
| NY | $4,323.75–$5,389.01 | 5 |
| OH | $4,177.90 | 1 |
| OK | $4,085.84 | 1 |
| OR | $4,517.74–$5,008.79 | 2 |
| PA | $4,196.88–$4,729.17 | 2 |
| PR | $4,590.41 | 1 |
| RI | $4,685.67 | 1 |
| SC | $4,219.01 | 1 |
| SD | $4,522.35 | 1 |
| TN | $4,145.30 | 1 |
| TX | $4,162.61–$4,785.90 | 8 |
| UT | $4,288.09 | 1 |
| VA | $4,463.01–$5,314.83 | 2 |
| VI | $4,590.41 | 1 |
| VT | $4,485.85 | 1 |
| WA | $4,763.88–$5,510.41 | 2 |
| WI | $4,344.29 | 1 |
| WV | $4,006.47 | 1 |
| WY | $4,535.84 | 1 |
How the 32994 rate is calculated
Each of 32994’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 · 32994
RVUs × geographic indexes × conversion factor
Work8.80
8.80 RVUs× 1.000 GPCI
Practice expense126.26
126.26 RVUs× 1.000 GPCI
Malpractice1.00
1.00 RVUs× 1.000 GPCI
Adjusted RVUs
136.0600
Conversion factor
$33.4009
Medicare rate
$4,544.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32994
The CMS indicators that decide how 32994 is paid alongside other services.
CMS payment indicators · 32994
Lung tumor ablation, percutaneous cryoablation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
32994 without 50 · national office
$4,544.53
Lung tumor ablation, percutaneous cryoablation
32994-50 · Bilateral: 150%
$6,816.80
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
32994 compared with similar codes
Compare codes · National
32994 vs 32998 vs 32999: Medicare rates
How to choose
- 32998Lung tumor ablationPercutaneous, radiofrequency
- Choose 32994 for cryoablation and 32998 for radiofrequency ablation; both describe percutaneous pulmonary tumor treatment with imaging guidance.
- 32999Unlisted lung procedureLungs and pleura
- Use 32999 for an unlisted lung or pleura procedure when a specific code does not describe the service; use 32994 for percutaneous cryoablation.
32994 billing questions
How does this differ from 32998?
32994 is for percutaneous cryoablation. Use 32998 when the pulmonary tumor is treated with radiofrequency ablation.
Is imaging guidance separately reportable?
No. Imaging guidance is included in 32994.
Does the code cover treatment of multiple tumors?
Yes. The code covers treatment of one or more pulmonary tumors in the described percutaneous cryoablation service.
What happens when another procedure is performed in the same session?
Medicare applies the standard multiple procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.
Can modifier 50 be used for bilateral treatment?
CMS identifies 32994 as bilateral; modifier 50 is paid at 150%. Document the bilateral service.
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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