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Billing code 32097: Lung nodule biopsyMedicare rate & RVUs

Report this code for an open thoracic approach that removes a wedge of lung containing a nodule for diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026109 payment localities222 Medicare services in 2024

Medicare pays $769.89 for 32097 nationally in a facility.

Medicare rate · 32097

Lung nodule biopsy

Work RVUs
13.41
Total RVUs
23.05
Global days
090

National rate · 2026

$769.89

Facility setting, before claim adjustments.

See every locality for 32097 →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 32097 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 32097 covers

A thoracic surgeon uses an open chest approach to remove a wedge of lung containing a nodule for diagnosis. The specimen is sent for pathologic evaluation; the operative record should establish that the target was a lung nodule and that the wedge was performed through an open approach. This service is typically performed in a hospital operating room.

Select this code for a diagnostic wedge resection of a nodule, rather than biopsy of a lung infiltrate or pleura. Document the target, surgical approach, and diagnostic purpose. The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. 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 32097 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

32097 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$695.38
Alaska*Unavailable$957.77
ArizonaUnavailable$747.38
ArkansasUnavailable$686.34
AtlantaUnavailable$796.90
AustinUnavailable$770.39
BakersfieldUnavailable$755.31
Baltimore/Surr. CntysUnavailable$818.75
BeaumontUnavailable$743.02
BrazoriaUnavailable$747.18

32097 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
32097 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 32097 rate is calculated

Each of 32097’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 · 32097

RVUs × geographic indexes × conversion factor

Work13.41

13.41 RVUs× 1.000 GPCI

Practice expense6.32

6.32 RVUs× 1.000 GPCI

Malpractice3.32

3.32 RVUs× 1.000 GPCI

Adjusted RVUs

23.0500

Conversion factor

$33.4009

Medicare rate

$769.89

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

Payment rules and modifiers for 32097

32097 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32097

Lung nodule 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 · 32097

Lung nodule 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.

  • 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

32097 without 51 · national facility

$769.89

Lung nodule biopsy

32097-51 · Second procedure: 50%

$384.95

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

32097 compared with similar codes

Compare codes · National

5 codes, side by side

  • 32097

    Lung nodule biopsy13.41 wRVU

    Not priced

  • 32096

    Lung biopsy13.41 wRVU

    Not priced

  • 32098

    Pleural biopsy12.59 wRVU

    Not priced

  • 32607

    Lung biopsy5.36 wRVU

    Not priced

  • 32505

    Lung wedge resection15.36 wRVU

    Not priced

How to choose

32096Lung biopsy
Choose 32097 for a diagnostic wedge resection of a lung nodule; choose 32096 for biopsy of lung infiltrates.
32098Pleural biopsy
32098 describes open diagnostic biopsy involving lung or pleura, while 32097 identifies a wedge resection directed at a lung nodule.
32607Lung biopsy
Both address diagnostic sampling of a lung nodule or mass, but 32607 is performed thoracoscopically and 32097 uses an open approach.
32505Lung wedge resection
Use 32097 when the wedge resection is diagnostic; 32505 describes a therapeutic wedge resection.

Codes related to 32097

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

Codes related to 32097
CodeHow it relatesNational office range
Same family
32096Lung biopsyOpen diagnostic biopsy directed at lung infiltrates rather than a nodule.No office rate
32098Pleural biopsyOpen diagnostic biopsy involving lung or pleura.No office rate
Used instead
32607Lung biopsyThoracoscopic diagnostic biopsy of a lung nodule or mass rather than an open approach.No office rate
32505Lung wedge resectionOpen therapeutic wedge resection when the intent is treatment rather than diagnostic sampling.No office rate

32097 billing questions

How does this differ from 32096?

Use 32097 for a diagnostic wedge resection directed at a lung nodule. Code 32096 is for diagnostic biopsy of lung infiltrates.

Is this the open code when the surgeon uses thoracoscopy?

No. This code describes an open approach. For a thoracoscopic diagnostic biopsy of a lung nodule or mass, compare 32607.

Does the 90-day global include postoperative care?

Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.

Can modifier 50 be used for nodules in both lungs?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction.

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 32097PPRRVU2026_Oct_nonQPP.csv, line 3,687 (RVU26D)

Open CMS sourceHow we calculate rates

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