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Billing code 32160: Open-chest massageMedicare rate & RVUs

Reports emergency thoracotomy with direct cardiac massage, typically during resuscitation when a patient in cardiac arrest requires open-chest intervention.

CMS RVU26DEffective Oct 1, 2026109 payment localities220 Medicare services in 2024

Medicare pays $772.23 for 32160 nationally in a facility.

Medicare rate · 32160

Open-chest massage

Swap in your local Medicare rate.

Work RVUs
12.77
Total RVUs
23.12
Global days
090

National rate · 2026

$772.23

Facility setting, before claim adjustments.

See every locality for 32160 → · 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 32160 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 32160 covers

This emergency procedure opens the chest to allow the surgeon to massage the heart directly. It is generally performed by a thoracic or trauma surgeon in a hospital setting, such as an emergency department or operating room, during resuscitation for cardiac arrest. A familiar situation is resuscitative thoracotomy after severe penetrating chest trauma when the team needs direct access to the heart.

Report the code when the operative record supports both thoracotomy and direct cardiac massage; routine external chest compressions alone are not this service. Document the arrest or resuscitation indication, the thoracotomy, and the open-chest cardiac intervention. The code has a 90-day global period, including the day-before preoperative visit and 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. Modifier 50 is inappropriate for this procedure. 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 32160 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

32160 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$697.02
Alaska*Unavailable$954.74
ArizonaUnavailable$749.81
ArkansasUnavailable$687.87
AtlantaUnavailable$798.20
AustinUnavailable$775.32
BakersfieldUnavailable$763.09
Baltimore/Surr. CntysUnavailable$821.27
BeaumontUnavailable$743.08
BrazoriaUnavailable$750.68

32160 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
32160 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 32160 rate is calculated

Each of 32160’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 · 32160

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.77Practice expense 7.25Malpractice 3.10

23.1200 adjusted RVUs×$33.4009 conversion factor=$772.23

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

Payment rules and modifiers for 32160

32160 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32160

Open-chest massage

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 · 32160

Open-chest massage

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

32160 without 51 · national facility

$772.23

Open-chest massage

32160-51 · Second procedure: 50%

$386.12

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

32160 compared with similar codes

Compare codes

32160 vs 32100 vs 32110 vs 32120: national Medicare rates

Swap in your local Medicare rate.

  • 32160
    Open-chest massage · 12.77 wRVU
    —
  • 32100
    Chest exploration · 13.41 wRVU
    —
  • 32110
    Chest exploration · 24.65 wRVU
    —
  • 32120
    Chest re-exploration · 14.03 wRVU
    —

How to choose

32100Chest exploration
32100 describes thoracotomy for chest exploration. Choose 32160 when the surgeon opens the chest and performs direct cardiac massage.
32110Chest exploration
32110 addresses thoracotomy with exploration and repair. This code is specific to thoracotomy with direct cardiac massage during resuscitation.
32120Chest re-exploration
32120 represents a different thoracotomy procedure. It is not a substitute when the documented intervention is open-chest cardiac massage.

Codes related to 32160

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

Codes related to 32160
CodeHow it relatesNational office range
Same family
32100Chest explorationA thoracotomy code for chest exploration; it does not identify direct cardiac massage.No office rate
32110Chest explorationA thoracotomy code associated with exploration and repair rather than open-chest cardiac massage.No office rate
32120Chest re-explorationA thoracotomy code for a different chest procedure, not direct cardiac massage.No office rate

32160 billing questions

How is this different from a chest exploration code?

Use this code when the surgeon performs direct cardiac massage through a thoracotomy. A thoracotomy for exploration or repair without open-chest massage has a different procedural objective.

Does the code include the thoracotomy incision?

Yes. The thoracotomy provides access for the direct cardiac massage described by the service; do not separately report the access incision.

Can modifier 50 be used?

No. Modifier 50 is inappropriate for this single thoracic resuscitation procedure.

What documentation supports reporting this code?

Document the resuscitation indication, the thoracotomy, and the direct cardiac massage. External chest compressions alone do not support this code.

How do the global and multiple-procedure rules affect payment?

The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% 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 32160PPRRVU2026_Oct_nonQPP.csv, line 3,699 (RVU26D)

Open CMS sourceHow we calculate rates

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