FeeBase
Log inGet started
Menu

Billing code 32661: Pericardial excisionMedicare rate & RVUs

Reports thoracoscopic surgical removal of a pericardial cyst or mass, rather than drainage alone or a biopsy of another thoracic structure.

CMS RVU26DEffective Oct 1, 2026109 payment localities79 Medicare services in 2024

Medicare pays $771.56 for 32661 nationally in a facility.

Medicare rate · 32661

Pericardial excision

Swap in your local Medicare rate.

Work RVUs
13
Total RVUs
23.10
Global days
090

National rate · 2026

$771.56

Facility setting, before claim adjustments.

See every locality for 32661 → · 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 32661 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 32661 covers

Code 32661 describes an operation in which the surgeon uses a thoracoscope to inspect the pericardium and excise a cyst or mass. It is typically performed by a thoracic or cardiothoracic surgeon in an operating room, often using a video-assisted thoracoscopic approach. The operative report should establish that the lesion arises from the pericardium and was excised; a procedure limited to draining the pericardial sac or sampling pleura is a different service.

Report the code for the thoracoscopic excision, and document the lesion’s location, the approach, and the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.

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 32661 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

32661 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$695.75
Alaska*Unavailable$954.63
ArizonaUnavailable$748.80
ArkansasUnavailable$686.54
AtlantaUnavailable$798.41
AustinUnavailable$773.27
BakersfieldUnavailable$759.17
Baltimore/Surr. CntysUnavailable$820.99
BeaumontUnavailable$743.27
BrazoriaUnavailable$749.02

32661 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
32661 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 32661 rate is calculated

Each of 32661’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 · 32661

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.00Practice expense 6.84Malpractice 3.26

23.1000 adjusted RVUs×$33.4009 conversion factor=$771.56

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

Payment rules and modifiers for 32661

32661 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32661

Pericardial excision

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)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 32661

Pericardial excision

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

32661 without 51 · national facility

$771.56

Pericardial excision

32661-51 · Second procedure: 50%

$385.78

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

32661 compared with similar codes

Compare codes

32661 vs 32659 vs 32662 vs 32609: national Medicare rates

Swap in your local Medicare rate.

  • 32661
    Pericardial excision · 13 wRVU
    —
  • 32659
    Pericardial drainage · 11.64 wRVU
    —
  • 32662
    Mediastinal excision · 14.62 wRVU
    —
  • 32609
    Pleural biopsy · 4.47 wRVU
    —

How to choose

32659Pericardial drainage
32661 is for excising a pericardial cyst or mass; 32659 is for thoracoscopic drainage of the pericardial sac.
32662Mediastinal excision
Choose based on the lesion’s origin: 32661 covers a pericardial lesion, while 32662 covers a mediastinal cyst, tumor, or mass.
32609Pleural biopsy
32661 removes a pericardial cyst or mass. Code 32609 is for thoracoscopic biopsy of pleura, not excision of a pericardial lesion.

Codes related to 32661

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

Codes related to 32661
CodeHow it relatesNational office range
Same family
32659Pericardial drainageThoracoscopic pericardial procedure for drainage rather than lesion excision.No office rate
32658ThoracoscopyThoracoscopic pericardial procedure for removing a foreign body.No office rate
Used instead
32662Mediastinal excisionFor thoracoscopic excision when the lesion is mediastinal rather than pericardial.No office rate

32661 billing questions

How is this different from 32659?

32661 is for thoracoscopic excision of a pericardial cyst or mass. Code 32659 describes thoracoscopic drainage of the pericardial sac.

When would 32662 be considered instead?

Use 32662 when the excised cyst, tumor, or mass is mediastinal rather than pericardial. The operative report should identify the structure of origin.

Does this code include drainage of the pericardial sac?

The service represented by 32661 is excision of a pericardial cyst or mass. Drainage alone is represented by 32659.

Can modifier 50 be appended for bilateral work?

No. Modifier 50 is inappropriate for this code.

What global period and multiple-procedure rules apply?

The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

What should the operative report document?

Document that the lesion is pericardial, the thoracoscopic approach, and the excision performed. If co-surgeon payment is claimed, supporting documentation is required.

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 32661PPRRVU2026_Oct_nonQPP.csv, line 3,757 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 32661 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 32661 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →