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Billing code 32096: Lung biopsyMedicare rate & RVUs

Reports an open surgical wedge biopsy of lung tissue with infiltrative changes when tissue is needed to establish a diagnosis.

CMS RVU26DEffective Oct 1, 2026109 payment localities93 Medicare services in 2024

Medicare pays $764.21 for 32096 nationally in a facility.

Medicare rate · 32096

Lung biopsy

Swap in your local Medicare rate.

Work RVUs
13.41
Total RVUs
22.88
Global days
090

National rate · 2026

$764.21

Facility setting, before claim adjustments.

See every locality for 32096 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 32096 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 32096 covers

The surgeon opens the chest and removes wedge samples from lung tissue showing infiltrative changes for diagnostic examination. A thoracic surgeon typically performs this operation in a hospital operating room when tissue is needed for pathologic evaluation, and sometimes for microbiologic studies. The target is an infiltrate rather than a discrete lung nodule or pleural tissue.

Select this code based on the tissue sampled and the open approach; document the infiltrative target, the biopsy performed, and the diagnostic purpose. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment does not apply, so modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 32096 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

32096 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$690.31
Alaska*Unavailable$951.56
ArizonaUnavailable$741.84
ArkansasUnavailable$681.35
AtlantaUnavailable$791.19
AustinUnavailable$764.32
BakersfieldUnavailable$748.92
Baltimore/Surr. CntysUnavailable$812.71
BeaumontUnavailable$737.86
BrazoriaUnavailable$741.48

32096 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
32096 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 32096 rate is calculated

Each of 32096’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 · 32096

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.41Practice expense 6.14Malpractice 3.33

22.8800 adjusted RVUs×$33.4009 conversion factor=$764.21

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 32096

32096 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32096

Lung biopsy

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 · 32096

Lung biopsy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

32096 without 51 · national facility

$764.21

Lung biopsy

32096-51 · Second procedure: 50%

$382.11

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

32096 compared with similar codes

Compare codes

32096 vs 32097 vs 32098 vs 32607 vs 32408: national Medicare rates

Swap in your local Medicare rate.

  • 32096
    Lung biopsy · 13.41 wRVU
    —
  • 32097
    Lung nodule biopsy · 13.41 wRVU
    —
  • 32098
    Pleural biopsy · 12.59 wRVU
    —
  • 32607
    Lung biopsy · 5.36 wRVU
    —
  • 32408
    Core biopsy · 3.1 wRVU
    $804.29

How to choose

32097Lung nodule biopsy
Choose 32096 for infiltrative lung tissue and 32097 for a discrete lung nodule. The target documented by the surgeon distinguishes these open biopsy codes.
32098Pleural biopsy
32096 samples lung tissue; 32098 samples pleura. Identify the anatomic tissue submitted for biopsy.
32607Lung biopsy
Both address biopsy of a lung infiltrate, but 32096 is the open approach and 32607 is the thoracoscopic approach.
32408Core biopsy
32408 describes percutaneous core needle sampling of lung or mediastinum; 32096 describes an open surgical wedge biopsy of lung tissue.

Codes related to 32096

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

Codes related to 32096
CodeHow it relatesNational office range
Same family
32097Lung nodule biopsyOpen lung biopsy code for a discrete nodule target rather than an infiltrative target.No office rate
32098Pleural biopsyOpen biopsy of pleural tissue rather than lung parenchyma.No office rate
Used instead
32607Lung biopsyThoracoscopic biopsy for a lung infiltrate when the surgeon uses a thoracoscopic approach.No office rate
32408Core biopsyPercutaneous core biopsy of lung or mediastinum instead of open surgical sampling.$701.58–$1,115.13

32096 billing questions

When is 32096 selected instead of 32097?

Use 32096 when the open biopsy targets lung tissue with infiltrative changes. Code 32097 is for a discrete lung nodule target.

Does this code describe a pleural biopsy?

No. It describes biopsy of lung tissue; 32098 is the related open biopsy code for pleural tissue.

Can modifier 50 be reported for bilateral lung biopsies?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What postoperative care is included in the global period?

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

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 32096PPRRVU2026_Oct_nonQPP.csv, line 3,686 (RVU26D)

Open CMS sourceHow we calculate rates

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