Billing code 32553: Radiation markerMedicare rate & RVUs
Percutaneous, image-guided placement of markers in a thoracic lesion supports radiation treatment planning and is reported for each lesion treated.
Medicare pays $491.33 for 32553 nationally in the office and $151.97 in a hospital or facility. Local office rates run $433.98–$658.63.
Medicare rate · 32553
Radiation marker
- Work RVUs
- 3.46
- Total RVUs
- 14.71
- Global days
- 000
National rate · 2026
$491.33
Office setting, before claim adjustments.
See every locality for 32553 →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
What 32553 covers
Code 32553 describes percutaneous placement of an interstitial marker, such as a fiducial, in a thoracic lesion to guide radiation treatment. An interventional radiologist, pulmonologist, or thoracic surgeon may place markers under imaging guidance, commonly for a lung tumor being planned for stereotactic radiation. Imaging guidance is part of the service described by this code.
Report one unit for each lesion receiving marker placement, and document the target lesion, percutaneous approach, imaging guidance, and placement performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. The descriptor is not bilateral; modifier 50 is inappropriate. CMS permits assistant-at-surgery payment, but not co-surgeon or team-surgery billing.
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 32553 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
$433.98 to $658.63
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $440.44 | $143.50 |
| Alaska* | $567.01 | $205.60 |
| Arizona | $478.24 | $149.41 |
| Arkansas | $433.98 | $142.47 |
| Atlanta | $500.03 | $155.25 |
| Austin | $511.17 | $152.13 |
| Bakersfield | $523.41 | $151.48 |
| Baltimore/Surr. Cntys | $522.69 | $158.56 |
| Beaumont | $457.75 | $148.94 |
| Brazoria | $486.19 | $149.89 |
| Chicago | $510.39 | $169.34 |
| Chico | $522.26 | $150.33 |
| Colorado | $513.17 | $152.10 |
| Connecticut | $524.26 | $158.78 |
| Dallas | $489.11 | $151.12 |
| Dc + Md/Va Suburbs | $563.63 | $163.87 |
| Delaware | $486.27 | $150.99 |
| Detroit | $487.33 | $159.85 |
| East St. Louis | $475.15 | $162.95 |
| El Centro | $522.32 | $150.39 |
| Fort Lauderdale | $506.30 | $162.54 |
| Fort Worth | $485.65 | $151.04 |
| Fresno | $522.26 | $150.33 |
| Galveston | $487.53 | $150.55 |
| Hanford-Corcoran | $522.26 | $150.33 |
| Hawaii, Guam | $535.72 | $149.88 |
| Houston | $494.48 | $157.50 |
| Idaho | $455.59 | $143.39 |
| Indiana | $458.30 | $143.72 |
| Iowa | $452.81 | $142.30 |
| Kansas | $450.18 | $143.40 |
| Kentucky | $449.95 | $148.26 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $558.24 | $156.79 |
| Madera | $522.26 | $150.33 |
| Manhattan | $564.98 | $170.65 |
| Merced | $522.26 | $150.33 |
| Metropolitan Boston | $565.10 | $159.92 |
| Metropolitan Kansas City | $468.89 | $150.24 |
| Metropolitan Philadelphia | $510.74 | $157.48 |
| Metropolitan St. Louis | $473.93 | $150.86 |
| Miami | $525.62 | $172.35 |
| Minnesota | $492.92 | $143.73 |
| Mississippi | $437.55 | $145.37 |
| Modesto | $522.26 | $150.33 |
| Montana** | $491.30 | $151.95 |
| Napa | $607.82 | $160.55 |
| Nebraska | $455.48 | $142.25 |
| Nevada** | $489.57 | $149.88 |
| New Hampshire | $504.63 | $151.36 |
| New Mexico | $463.74 | $152.56 |
| New Orleans | $471.63 | $152.30 |
| North Carolina | $462.42 | $145.80 |
| North Dakota** | $483.79 | $144.43 |
| Northern Nj | $557.56 | $163.91 |
| Nyc Suburbs/Long Island | $578.22 | $174.73 |
| Ohio | $459.84 | $150.01 |
| Oklahoma | $449.65 | $146.61 |
| Oxnard-Thousand Oaks-Ventura | $555.86 | $154.74 |
| Portland | $530.23 | $153.21 |
| Poughkpsie/N Nyc Suburbs | $533.68 | $162.09 |
| Puerto Rico | $495.13 | $152.04 |
| Queens | $570.41 | $169.30 |
| Redding | $522.26 | $150.33 |
| Rest Of California | $522.26 | $150.33 |
| Rest Of Florida | $481.74 | $157.31 |
| Rest Of Georgia | $454.55 | $151.85 |
| Rest Of Illinois | $466.89 | $157.06 |
| Rest Of Louisiana | $449.04 | $148.71 |
| Rest Of Maine | $457.48 | $145.28 |
| Rest Of Maryland | $495.80 | $152.37 |
| Rest Of Massachusetts | $509.84 | $152.50 |
| Rest Of Michigan | $461.38 | $151.55 |
| Rest Of Missouri | $440.89 | $148.37 |
| Rest Of New Jersey | $530.58 | $160.01 |
| Rest Of New York | $469.40 | $147.02 |
| Rest Of Oregon | $486.11 | $148.11 |
| Rest Of Pennsylvania | $460.86 | $149.33 |
| Rest Of Texas | $471.58 | $149.53 |
| Rest Of Washington | $509.04 | $151.70 |
| Rhode Island | $504.13 | $153.58 |
| Riverside-San Bernardino-Ontario | $526.40 | $154.47 |
| Sacramento-Roseville-Folsom | $548.78 | $154.11 |
| Salinas | $546.75 | $153.44 |
| San Diego-Chula Vista-Carlsbad | $560.14 | $154.28 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $644.30 | $165.81 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $643.87 | $165.38 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $658.63 | $169.28 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $656.86 | $167.51 |
| San Luis Obispo-Paso Robles | $537.87 | $151.35 |
| Santa Cruz-Watsonville | $565.92 | $153.61 |
| Santa Maria-Santa Barbara | $548.94 | $153.26 |
| Santa Rosa-Petaluma | $571.68 | $154.96 |
| Seattle (King Cnty) | $577.20 | $160.81 |
| South Carolina | $461.83 | $148.27 |
| South Dakota** | $482.90 | $143.55 |
| Southern Maine | $483.38 | $147.08 |
| Stockton | $522.26 | $150.33 |
| Suburban Chicago | $511.74 | $163.22 |
| Tennessee | $452.41 | $143.94 |
| Utah | $468.25 | $149.26 |
| Vallejo | $607.20 | $159.93 |
| Vermont | $481.43 | $145.47 |
| Virgin Islands | $495.13 | $152.04 |
| Virginia | $481.42 | $147.84 |
| Visalia | $522.26 | $150.33 |
| West Virginia | $449.24 | $154.34 |
| Wisconsin | $467.30 | $142.19 |
| Wyoming** | $488.03 | $148.67 |
| Yuba City | $522.26 | $150.33 |
32553 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.
$433.98
$590.44
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $567.01 | 1 |
| AL | $440.44 | 1 |
| AR | $433.98 | 1 |
| AZ | $478.24 | 1 |
| CA | $522.26–$658.63 | 29 |
| CO | $513.17 | 1 |
| CT | $524.26 | 1 |
| DC | $563.63 | 1 |
| DE | $486.27 | 1 |
| FL | $481.74–$525.62 | 3 |
| GA | $454.55–$500.03 | 2 |
| GU | $535.72 | 1 |
| HI | $535.72 | 1 |
| IA | $452.81 | 1 |
| ID | $455.59 | 1 |
| IL | $466.89–$511.74 | 4 |
| IN | $458.30 | 1 |
| KS | $450.18 | 1 |
| KY | $449.95 | 1 |
| LA | $449.04–$471.63 | 2 |
| MA | $509.84–$565.10 | 2 |
| MD | $495.80–$563.63 | 3 |
| ME | $457.48–$483.38 | 2 |
| MI | $461.38–$487.33 | 2 |
| MN | $492.92 | 1 |
| MO | $440.89–$473.93 | 3 |
| MS | $437.55 | 1 |
| MT | $491.30 | 1 |
| NC | $462.42 | 1 |
| ND | $483.79 | 1 |
| NE | $455.48 | 1 |
| NH | $504.63 | 1 |
| NJ | $530.58–$557.56 | 2 |
| NM | $463.74 | 1 |
| NV | $489.57 | 1 |
| NY | $469.40–$578.22 | 5 |
| OH | $459.84 | 1 |
| OK | $449.65 | 1 |
| OR | $486.11–$530.23 | 2 |
| PA | $460.86–$510.74 | 2 |
| PR | $495.13 | 1 |
| RI | $504.13 | 1 |
| SC | $461.83 | 1 |
| SD | $482.90 | 1 |
| TN | $452.41 | 1 |
| TX | $457.75–$511.17 | 8 |
| UT | $468.25 | 1 |
| VA | $481.42–$563.63 | 2 |
| VI | $495.13 | 1 |
| VT | $481.43 | 1 |
| WA | $509.04–$577.20 | 2 |
| WI | $467.30 | 1 |
| WV | $449.24 | 1 |
| WY | $488.03 | 1 |
How the 32553 rate is calculated
Each of 32553’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 · 32553
RVUs × geographic indexes × conversion factor
Work3.46
3.46 RVUs× 1.000 GPCI
Practice expense10.87
10.87 RVUs× 1.000 GPCI
Malpractice0.38
0.38 RVUs× 1.000 GPCI
Adjusted RVUs
14.7100
Conversion factor
$33.4009
Medicare rate
$491.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32553
The CMS indicators that decide how 32553 is paid alongside other services.
CMS payment indicators · 32553
Radiation marker
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
32553 without 51 · national office
$491.33
Radiation marker
32553-51 · Second procedure: 50%
$245.67
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%).
32553 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 31626Fiducial placement
- Use 31626 when marker placement is performed through a bronchoscope. Use 32553 for percutaneous placement through the chest wall.
- 10035Soft-tissue localization
- 10035 describes percutaneous placement of a soft-tissue localization device, generally for localization rather than radiation treatment guidance. Code 32553 is specific to interstitial devices placed for radiation guidance.
- 32555Thoracentesis
- 32555 is image-guided aspiration of pleural fluid. It treats a pleural fluid collection, not placement of a marker in a lesion for radiation guidance.
32553 billing questions
How does 32553 differ from bronchoscopic marker placement?
32553 is for percutaneous placement through the chest wall with imaging guidance. billing code 31626 describes marker placement by a bronchoscopic approach.
How many units should be reported for multiple lesions?
Report a unit for each lesion receiving marker placement. The procedure documentation should identify the treated lesion or lesions and the placement performed at each.
Is imaging guidance separately reported?
Imaging guidance is included in the service described by 32553. Do not report it separately for guidance used to perform that marker placement.
Should modifier 50 be used for markers placed on both sides?
No. The descriptor is not bilateral, and modifier 50 is inappropriate. Report the service by lesion treated.
Can an assistant-at-surgery or co-surgeon be billed?
CMS permits assistant-at-surgery payment for this code. Co-surgeon and team-surgery billing are not permitted.
What happens when 32553 is performed with another procedure?
For procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% 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
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