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Billing code 32655: Bulla resectionMedicare rate & RVUs

Reports thoracoscopic removal of pulmonary bullae, commonly during surgery for spontaneous pneumothorax or symptomatic bullous lung disease.

CMS RVU26DEffective Oct 1, 2026109 payment localities790 Medicare services in 2024

Medicare pays $915.85 for 32655 nationally in a facility.

Medicare rate · 32655

Bulla resection

Swap in your local Medicare rate.

Work RVUs
15.77
Total RVUs
27.42
Global days
090

National rate · 2026

$915.85

Facility setting, before claim adjustments.

See every locality for 32655 → · 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 32655 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 32655 covers

A thoracic surgeon uses a thoracoscopic approach to remove one or more abnormal air-filled spaces in the lung, often to treat a persistent or recurrent spontaneous pneumothorax or symptomatic bullous disease. The service is generally performed in an operating room, with the resected bulla removed through the thoracic access sites. The code includes pleural procedures performed as part of the bulla resection.

The operative report should identify the bulla resected, its location, the thoracoscopic approach, and the clinical reason for surgery. This major procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 32655 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

32655 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$826.45
Alaska*Unavailable$1,136.70
ArizonaUnavailable$888.88
ArkansasUnavailable$815.60
AtlantaUnavailable$948.07
AustinUnavailable$916.78
BakersfieldUnavailable$898.96
Baltimore/Surr. CntysUnavailable$974.32
BeaumontUnavailable$883.34
BrazoriaUnavailable$888.73

32655 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
32655 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 32655 rate is calculated

Each of 32655’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 · 32655

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.77Practice expense 7.70Malpractice 3.95

27.4200 adjusted RVUs×$33.4009 conversion factor=$915.85

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

Payment rules and modifiers for 32655

32655 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32655

Bulla 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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 32655

Bulla 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 50 · payment effect

With and without the modifier

32655 without 50 · national facility

$915.85

Bulla resection

32655-50 · Bilateral: 150%

$1,373.78

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

32655 compared with similar codes

Compare codes

32655 vs 32666 vs 32650 vs 32656 vs 32651: national Medicare rates

Swap in your local Medicare rate.

  • 32655
    Bulla resection · 15.77 wRVU
    —
  • 32666
    Lung wedge resection · 14.14 wRVU
    —
  • 32650
    Pleurodesis · 10.56 wRVU
    —
  • 32656
    Thoracoscopic pleurectomy · 12.93 wRVU
    —
  • 32651
    Thoracoscopic decortication · 18.31 wRVU
    —

How to choose

32666Lung wedge resection
32655 is for resection of pulmonary bullae. Use 32666 when the surgeon performs a thoracoscopic wedge resection for another lung target.
32650Pleurodesis
32650 describes thoracoscopic pleurodesis. Pleural work performed as part of 32655 is included in the bulla-resection service.
32656Thoracoscopic pleurectomy
32656 is thoracoscopic pleurectomy. It is distinguished by removal of pleural tissue as the operative service rather than resection of a pulmonary bulla.
32651Thoracoscopic decortication
32651 describes thoracoscopic decortication, which removes a restrictive layer from the lung or pleura; 32655 removes pulmonary bullae.

Codes related to 32655

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

Codes related to 32655
CodeHow it relatesNational office range
Used instead
32650PleurodesisThoracoscopic pleurodesis without bulla resection is the distinct service.No office rate
32656Thoracoscopic pleurectomyThoracoscopic pleurectomy is selected when pleural tissue removal is the operative target.No office rate
32666Lung wedge resectionThoracoscopic wedge resection applies to a lung target other than a bulla.No office rate
32651Thoracoscopic decorticationThoracoscopic decortication addresses a restrictive pleural peel, not bulla removal.No office rate

32655 billing questions

How is 32655 different from thoracoscopic wedge resection?

Use 32655 when the target is a pulmonary bulla. Code 32666 describes thoracoscopic wedge resection for a different lung target, such as a lesion requiring wedge removal.

Can pleurodesis be reported separately with 32655?

Pleural procedures performed as part of the bulla resection are included in 32655. Do not separately report 32650 for pleurodesis that is part of that service.

What documentation supports 32655?

Document the thoracoscopic approach, the bulla removed and its lung location, and the indication, such as persistent pneumothorax or symptomatic bullous disease.

How does Medicare handle bilateral bulla resection?

The CMS rule pays bilateral reporting with modifier 50 at 150%. The operative record should support treatment on both sides.

What postoperative care is included?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; 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 32655PPRRVU2026_Oct_nonQPP.csv, line 3,752 (RVU26D)

Open CMS sourceHow we calculate rates

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