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Billing code 32503: Lung tumor resectionMedicare rate & RVUs

Open resection of an apical lung tumor with involved chest wall, reported when the operation does not include chest wall reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $1,693.09 for 32503 nationally in a facility.

Medicare rate · 32503

Lung tumor resection

Swap in your local Medicare rate.

Work RVUs
30.95
Total RVUs
50.69
Global days
090

National rate · 2026

$1,693.09

Facility setting, before claim adjustments.

See every locality for 32503 → · 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 32503 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 32503 covers

Code 32503 represents an open major thoracic operation to remove an apical lung tumor, commonly a superior sulcus (Pancoast) tumor, together with involved chest wall. A thoracic surgeon performs the resection through thoracotomy in an operating room. The code distinguishes the operation in which the chest wall is not reconstructed. The specimen may include the apical lung lesion and a contiguous portion of chest wall removed as one oncologic resection.

Report 32503 when the operative report supports apical tumor resection with chest wall resection and no chest wall reconstruction; a diagnostic wedge resection or a lung resection without this apical and chest wall operation is not equivalent. The record should identify tumor location, structures removed, and whether reconstruction occurred. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. 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 32503 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

32503 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,530.07
Alaska*Unavailable$2,118.74
ArizonaUnavailable$1,643.17
ArkansasUnavailable$1,510.39
AtlantaUnavailable$1,755.00
AustinUnavailable$1,688.53
BakersfieldUnavailable$1,648.99
Baltimore/Surr. CntysUnavailable$1,800.54
BeaumontUnavailable$1,638.71
BrazoriaUnavailable$1,640.39

32503 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
32503 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 32503 rate is calculated

Each of 32503’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 · 32503

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 30.95Practice expense 11.93Malpractice 7.81

50.6900 adjusted RVUs×$33.4009 conversion factor=$1,693.09

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

Payment rules and modifiers for 32503

32503 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32503

Lung tumor resection

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 · 32503

Lung tumor resection

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

32503 without 51 · national facility

$1,693.09

Lung tumor resection

32503-51 · Second procedure: 50%

$846.55

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

32503 compared with similar codes

Compare codes

32503 vs 32504 vs 32505 vs 32507: national Medicare rates

Swap in your local Medicare rate.

  • 32503
    Lung tumor resection · 30.95 wRVU
    —
  • 32504
    Apical tumor resection · 35.63 wRVU
    —
  • 32505
    Lung wedge resection · 15.36 wRVU
    —
  • 32507
    Lung wedge resection · 2.93 wRVU
    —

How to choose

32504Apical tumor resection
Both codes include apical tumor and chest wall resection. Select 32504 when the chest wall is reconstructed; select 32503 when it is not.
32505Lung wedge resection
32505 describes an open wedge or segmental lung resection. It does not represent the apical tumor resection with chest wall resection described by 32503.
32507Lung wedge resection
32507 is for diagnostic lung wedge resection. 32503 represents therapeutic resection of an apical tumor with involved chest wall.

Codes related to 32503

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

Codes related to 32503
CodeHow it relatesNational office range
Same family
32504Apical tumor resectionApical lung tumor resection with chest wall reconstruction.No office rate
Used instead
32505Lung wedge resectionOpen lung wedge or segmental resection when the apical tumor and chest wall operation is not performed.No office rate
32507Lung wedge resectionDiagnostic lung wedge resection rather than apical tumor resection with chest wall resection.No office rate

32503 billing questions

What distinguishes 32503 from 32504?

Both describe apical lung tumor resection with chest wall resection. Use 32503 when the chest wall is not reconstructed and 32504 when reconstruction is performed.

Can the chest wall resection be billed separately?

Chest wall resection is part of the operation represented by 32503. The operative report should establish that it was performed as part of the apical tumor resection.

What should the operative report document?

Document the apical tumor location, lung and chest wall structures removed, and whether chest wall reconstruction was performed.

How does the multiple procedure reduction work?

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.

What are the global and surgical team payment rules?

The 90-day global includes the day-before preoperative visit and related postoperative care. An assistant at surgery may be paid, co-surgeon payment requires supporting documentation, and 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 32503PPRRVU2026_Oct_nonQPP.csv, line 3,722 (RVU26D)

Open CMS sourceHow we calculate rates

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