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Billing code 32140: BullectomyMedicare rate & RVUs

Reports open thoracotomy to remove or plicate pulmonary bullae, commonly for bullous lung disease associated with persistent air leak or pneumothorax.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $955.27 for 32140 nationally in a facility.

Medicare rate · 32140

Bullectomy

Swap in your local Medicare rate.

Work RVUs
16.24
Total RVUs
28.60
Global days
090

National rate · 2026

$955.27

Facility setting, before claim adjustments.

See every locality for 32140 → · 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 32140 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 32140 covers

A thoracic surgeon uses an open chest approach to excise or plicate pulmonary bullae, often in patients with bullous emphysema or a pneumothorax related to a bulla. The operation includes the pleural work performed as part of this service. It is distinct from taking a diagnostic sample or removing a lung lobe, and is generally performed in an operating room under general anesthesia.

Report the code when the operative note supports open thoracotomy with bullae excision or plication. Documentation should identify the bullae treated, the approach, and the operative work performed. The CMS global period 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 reduction. Report the operation as performed rather than using modifier 50 for bilateral work. 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 32140 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

32140 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$861.55
Alaska*Unavailable$1,183.27
ArizonaUnavailable$927.07
ArkansasUnavailable$850.18
AtlantaUnavailable$988.71
AustinUnavailable$956.86
BakersfieldUnavailable$938.84
Baltimore/Surr. CntysUnavailable$1,016.43
BeaumontUnavailable$920.70
BrazoriaUnavailable$927.14

32140 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
32140 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 32140 rate is calculated

Each of 32140’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 · 32140

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.24Practice expense 8.28Malpractice 4.08

28.6000 adjusted RVUs×$33.4009 conversion factor=$955.27

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

Payment rules and modifiers for 32140

32140 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32140

Bullectomy

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 · 32140

Bullectomy

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

32140 without 51 · national facility

$955.27

Bullectomy

32140-51 · Second procedure: 50%

$477.64

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

32140 compared with similar codes

Compare codes

32140 vs 32655 vs 32505 vs 32480 vs 32100: national Medicare rates

Swap in your local Medicare rate.

  • 32140
    Bullectomy · 16.24 wRVU
    —
  • 32655
    Bulla resection · 15.77 wRVU
    —
  • 32505
    Lung wedge resection · 15.36 wRVU
    —
  • 32480
    Lung resection · 25.17 wRVU
    —
  • 32100
    Chest exploration · 13.41 wRVU
    —

How to choose

32655Bulla resection
Both address bullae excision or plication, but 32655 uses a thoracoscopic approach; 32140 is the open thoracotomy service.
32505Lung wedge resection
32505 describes an open therapeutic wedge resection for a lung lesion. Use 32140 for open excision or plication of bullae.
32480Lung resection
32480 is a lobectomy, removing a lung lobe. 32140 treats bullae without describing lobar removal.
32100Chest exploration
32100 is limited thoracotomy for lung or pleural biopsy; 32140 is therapeutic bullae surgery rather than diagnostic sampling.

Codes related to 32140

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

Codes related to 32140
CodeHow it relatesNational office range
Used instead
32655Bulla resectionThoracoscopic approach for bullae excision or plication, rather than open thoracotomy.No office rate
32505Lung wedge resectionOpen therapeutic wedge resection for a lung lesion rather than bullae excision or plication.No office rate
32480Lung resectionLobectomy when the operative plan removes a lung lobe rather than treating bullae.No office rate

32140 billing questions

When is this code appropriate instead of a lung biopsy code?

Use it for open thoracotomy with excision or plication of bullae, not for an operation whose purpose is only to obtain a diagnostic lung sample.

Is pleural work performed during the bullectomy separately reported?

Pleural procedures performed as part of this service are included. Do not separately report that included pleural work.

Should modifier 50 be used for bullae treated on both sides?

No. Report the procedure performed without modifier 50; CMS does not provide a bilateral adjustment for this code.

Can an assistant surgeon be reported?

CMS indicates that assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.

How does the multiple-procedure reduction affect another operation in the same session?

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

What postoperative care is included?

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

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 32140PPRRVU2026_Oct_nonQPP.csv, line 3,694 (RVU26D)

Open CMS sourceHow we calculate rates

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