Billing code 32606: Thoracoscopy biopsyMedicare rate & RVUs

Medicare pays $428.53 for 32606 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 32606 covers

A thoracic surgeon uses a scope and instruments introduced through chest-wall ports to inspect the chest and obtain tissue from a mediastinal mass or lesion. The specimen may help evaluate an abnormality seen on imaging or clarify a suspected mediastinal disease. The service is generally performed in an operating room with the patient under anesthesia; it is not the code for sampling a lung nodule, pulmonary infiltrate, pleura, or pericardial sac.

Select the code according to the sampled target and thoracoscopic approach, and document the mediastinal site, the biopsy performed, and the operative findings. Biopsies of multiple portions of a mediastinal mass during the same session are reported as the procedure, not as separate units for each specimen. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are 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. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 32606 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

32606 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 32606 rate is calculated

Each of 32606’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.

Payment rules and modifiers for 32606

The CMS indicators that decide how 32606 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

32606 compared with similar codes

How to choose

32601Diagnostic thoracoscopy

Use 32601 for diagnostic thoracoscopy without the mediastinal mass biopsy described here. When the surgeon biopsies the mediastinal target, select the biopsy service.

32607Lung biopsy

32607 is for thoracoscopic biopsy of a pulmonary infiltrate. This code is selected when the tissue comes from a mediastinal mass or lesion.

32608Thoracoscopic biopsy

32608 describes biopsy of a lung nodule. Choose this code for a mediastinal mass biopsy, not a nodule within lung parenchyma.

32662Mediastinal excision

32662 describes thoracoscopic excision of a mediastinal lesion. This code applies when the surgeon obtains biopsy tissue rather than performing the excision service.

Codes related to 32606

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

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

Open CMS sourceHow we calculate rates