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Billing code 32653: Thoracoscopy removalMedicare rate & RVUs

Reports thoracoscopic removal of a foreign object or fibrin deposit from the pleural space during an operative chest procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.8K Medicare services in 2024

Medicare pays $1,006.37 for 32653 nationally in a facility.

Medicare rate · 32653

Thoracoscopy removal

Work RVUs
17.72
Total RVUs
30.13
Global days
090

National rate · 2026

$1,006.37

Facility setting, before claim adjustments.

See every locality for 32653 →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 32653 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 32653 covers

A thoracic surgeon uses a thoracoscope to remove a foreign object or fibrinous material from the pleural space. The work is performed in an operating room, commonly during surgery for a retained intrathoracic object or fibrin deposit requiring operative removal. The operative report should identify the material and its location and describe its removal through the thoracoscopic approach.

Report this code when removal of the foreign body or fibrin deposit is the operative service, rather than pleural decortication or removal of an object from the pericardial sac. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require 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 32653 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

32653 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$910.90
Alaska*Unavailable$1,256.62
ArizonaUnavailable$977.55
ArkansasUnavailable$899.32
AtlantaUnavailable$1,040.91
AustinUnavailable$1,007.29
BakersfieldUnavailable$988.60
Baltimore/Surr. CntysUnavailable$1,069.27
BeaumontUnavailable$971.75
BrazoriaUnavailable$977.56

32653 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
32653 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 32653 rate is calculated

Each of 32653’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 · 32653

RVUs × geographic indexes × conversion factor

Work17.72

17.72 RVUs× 1.000 GPCI

Practice expense8.18

8.18 RVUs× 1.000 GPCI

Malpractice4.23

4.23 RVUs× 1.000 GPCI

Adjusted RVUs

30.1300

Conversion factor

$33.4009

Medicare rate

$1,006.37

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 32653

32653 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32653

Thoracoscopy removal

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 · 32653

Thoracoscopy removal

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

32653 without 51 · national facility

$1,006.37

Thoracoscopy removal

32653-51 · Second procedure: 50%

$503.19

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

32653 compared with similar codes

Compare codes · National

4 codes, side by side

  • 32653

    Thoracoscopy removal17.72 wRVU

    Not priced

  • 32651

    Thoracoscopic decortication18.31 wRVU

    Not priced

  • 32652

    Thoracoscopic decortication28.4 wRVU

    Not priced

  • 32658

    Thoracoscopy11.42 wRVU

    Not priced

How to choose

32651Thoracoscopic decortication
32651 describes partial decortication. Choose 32653 when the operative service is removal of a foreign body or fibrin deposit, not decortication.
32652Thoracoscopic decortication
32652 describes total decortication. The operative goal and extent of decortication distinguish it from removal reported with 32653.
32658Thoracoscopy
32658 is for removing a foreign body from the pericardial sac; 32653 is used for the corresponding removal service in the pleural space.

Codes related to 32653

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

Codes related to 32653
CodeHow it relatesNational office range
Used instead
32651Thoracoscopic decorticationFor thoracoscopic partial decortication rather than removal of a foreign body or fibrin deposit.No office rate
32652Thoracoscopic decorticationFor thoracoscopic total decortication rather than removal of a foreign body or fibrin deposit.No office rate
32658ThoracoscopyFor thoracoscopic foreign-body removal when the object is in the pericardial sac.No office rate

32653 billing questions

How is this different from thoracoscopic decortication?

Use 32653 for removal of a foreign body or fibrin deposit. Codes 32651 and 32652 describe partial and total lung decortication, respectively; select based on the operation documented.

When is 32658 the better code?

32658 is for thoracoscopic removal of a foreign body from the pericardial sac. Use 32653 for the removal service involving the pleural space.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor or anatomy.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard 50% multiple-procedure reduction to the other procedures.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons require supporting documentation, while 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 32653PPRRVU2026_Oct_nonQPP.csv, line 3,750 (RVU26D)

Open CMS sourceHow we calculate rates

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