Billing code 32400: Pleural biopsyMedicare rate & RVUs

Reports percutaneous needle sampling of pleural tissue when a clinician needs a tissue diagnosis from the lining around the lungs.

CMS RVU26DEffective Oct 1, 2026109 payment localities998 Medicare services in 2024

Medicare pays $166.34 for 32400 nationally in the office and $72.48 in a hospital or facility. Local office rates run $148.92–$215.34.

Medicare rate · 32400

Pleural biopsy

Swap in your local Medicare rate.

Work RVUs
1.72
Total RVUs
4.98
Global days
000

National rate · 2026

$166.34

Office setting, before claim adjustments.

See every locality for 32400 → · 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 32400 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 32400 covers

A clinician passes a needle through the chest wall to obtain pleural tissue for diagnostic evaluation. Pulmonologists, interventional radiologists, and thoracic surgeons may perform the procedure, often in a hospital setting. The target is the pleura, not a lung nodule or mediastinal mass; aspiration of pleural fluid alone is a different service.

Report this code when the needle biopsy samples pleural tissue, and document the target, percutaneous approach, and reason tissue was needed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and 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 32400 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

$148.92 to $215.34

$148.92$182.13$215.34
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

32400 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$150.87$68.74
Alaska*$199.05$99.09
Arizona$162.28$71.33
Arkansas$148.92$68.29
Atlanta$169.36$74.01
Austin$171.73$72.43
Bakersfield$174.95$72.09
Baltimore/Surr. Cntys$176.19$75.48
Beaumont$156.65$71.24
Brazoria$164.55$71.54

32400 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.

$148.92

$199.05

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
32400 office rate range by state
State / territoryOffice rate rangeLocalities
AK$199.051
AL$150.871
AR$148.921
AZ$162.281
CA$174.40–$215.3429
CO$172.291
CT$176.671
DC$188.431
DE$164.781
FL$164.83–$179.753
GA$156.38–$169.362
GU$177.901
HI$177.901
IA$153.971
ID$154.941
IL$160.77–$175.044
IN$155.741
KS$153.481
KY$154.411
LA$154.25–$161.082
MA$171.49–$187.992
MD$167.65–$188.433
ME$155.83–$163.192
MI$158.16–$166.862
MN$165.091
MO$151.98–$161.413
MS$150.471
MT$166.321
NC$157.271
ND$162.771
NE$154.681
NH$169.801
NJ$178.68–$186.822
NM$159.011
NV$165.441
NY$159.41–$194.615
OH$157.431
OK$153.991
OR$164.14–$177.142
PA$157.57–$172.752
PR$167.381
RI$170.171
SC$157.621
SD$162.341
TN$154.191
TX$156.65–$171.738
UT$159.551
VA$162.82–$188.432
VI$167.381
VT$162.341
WA$171.10–$191.462
WI$157.861
WV$155.451
WY$164.771

How the 32400 rate is calculated

Each of 32400’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 · 32400

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.72Practice expense 3.08Malpractice 0.18

4.9800 adjusted RVUs×$33.4009 conversion factor=$166.34

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

Payment rules and modifiers for 32400

The CMS indicators that decide how 32400 is paid alongside other services.

CMS payment indicators · 32400

Pleural biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

32400 without 51 · national office

$166.34

Pleural biopsy

32400-51 · Second procedure: 50%

$83.17

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

32400 compared with similar codes

Compare codes

32400 vs 32408 vs 32609 vs 32555: national Medicare rates

Swap in your local Medicare rate.

  • 32400
    Pleural biopsy · 1.72 wRVU
    $166.34
  • 32408
    Core biopsy · 3.1 wRVU
    $804.29+$637.95
  • 32609
    Pleural biopsy · 4.47 wRVU
    —
  • 32555
    Thoracentesis · 2.21 wRVU
    $310.96+$144.62

How to choose

32408Core biopsy
Choose 32400 for pleural tissue sampled percutaneously; choose 32408 when the needle core biopsy targets lung or mediastinal tissue.
32609Pleural biopsy
This code describes percutaneous needle sampling of pleura. Code 32609 is used when pleural biopsy is performed during diagnostic thoracoscopy.
32555Thoracentesis
Code 32555 describes image-guided aspiration of pleural fluid. Use 32400 when the procedure obtains pleural tissue rather than fluid.

32400 billing questions

How do I distinguish this from 32408?

Use 32400 for needle sampling of pleural tissue. Code 32408 describes percutaneous core biopsy of lung or mediastinal tissue.

Can I report this for pleural fluid removal?

No. This code is for tissue sampling. Thoracentesis codes describe pleural fluid aspiration.

Is modifier 50 appropriate for a biopsy on both sides?

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

Can an assistant or co-surgeon be paid?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What documentation supports reporting the biopsy?

Document that the target was pleura, that tissue was obtained by a percutaneous needle approach, and the clinical reason for tissue sampling.

How does the multiple-procedure reduction affect payment?

For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures 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 32400PPRRVU2026_Oct_nonQPP.csv, line 3,710 (RVU26D)

Open CMS sourceHow we calculate rates

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