Use 32486 when the operation includes bronchial sleeve resection and airway reconstruction with the lobectomy. A lobectomy without that reconstruction is represented by 32480.
On this page
CMS RVU26D · Effective 2026-10-01
32486 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$2142.33
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Thoracic surgery
About 32486: Sleeve lobectomy with bronchial reconstruction
Reports lung resection combining lobectomy with bronchial sleeve reconstruction, typically for a central airway lesion when preserving the remaining lung is feasible.
A sleeve lobectomy removes an affected lung lobe together with the involved portion of bronchus, then reconnects the airway to preserve the remaining lung. Thoracic surgeons most often perform it in an operating room for a central lung lesion involving a lobar bronchus when resection with airway reconstruction is appropriate. The operation combines the lung resection and bronchial reconstruction in one service; it is distinct from removing an entire lung.
Report 32486 when the operative record supports both lobectomy and bronchial sleeve resection with airway reconstruction, rather than a conventional lobectomy alone. Documentation should identify the lobe removed, the bronchial resection and reconstruction, and the operative findings supporting the approach. The 90-day global period includes 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% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32486
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU41.81 · 64%
- Practice expense (office) RVU12.79 · 20%
- Malpractice RVU10.55 · 16%
45
Medicare services in 2024 · #5415 by national volume
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.
32486 compared with similar codes
Office rates for Delaware, from the same CMS release.
32482 represents removal of two lobes. 32486 represents a lobectomy with bronchial sleeve resection and reconstruction, not a bilobectomy.
32442 is a sleeve pneumonectomy, involving removal of the entire lung. 32486 preserves the remaining lung after removal of the affected lobe and airway reconstruction.
32440 represents removal of an entire lung without the sleeve-pneumonectomy distinction. Choose 32486 for lobectomy with bronchial sleeve reconstruction and lung preservation.
The same code, a different location
How does Delaware compare?
32486 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 32486
Office
Unavailable
Facility
$1969.74
No comparable office rate is available.
Arkansas
Arkansas · 32486
Office
Unavailable
Facility
$1944.93
No comparable office rate is available.
Arizona
Arizona · 32486
Office
Unavailable
Facility
$2112.08
No comparable office rate is available.
Bakersfield
California · 32486
Office
Unavailable
Facility
$2105.83
No comparable office rate is available.
Chico
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
El Centro
California · 32486
Office
Unavailable
Facility
$2079.08
No comparable office rate is available.
Fresno
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Hanford-Corcoran
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Madera
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Merced
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Modesto
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Napa
California · 32486
Office
Unavailable
Facility
$2226.53
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 32486
Office
Unavailable
Facility
$2160.07
No comparable office rate is available.
Redding
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Rest Of California
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 32486
Office
Unavailable
Facility
$2190.42
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 32486
Office
Unavailable
Facility
$2132.47
No comparable office rate is available.
Salinas
California · 32486
Office
Unavailable
Facility
$2123.78
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 32486
Office
Unavailable
Facility
$2140.30
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 32486
Office
Unavailable
Facility
$2293.25
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 32486
Office
Unavailable
Facility
$2281.27
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 32486
Office
Unavailable
Facility
$2355.00
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 32486
Office
Unavailable
Facility
$2306.02
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 32486
Office
Unavailable
Facility
$2095.69
No comparable office rate is available.
Santa Cruz-Watsonville
California · 32486
Office
Unavailable
Facility
$2133.74
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 32486
Office
Unavailable
Facility
$2122.58
No comparable office rate is available.
Santa Rosa-Petaluma
California · 32486
Office
Unavailable
Facility
$2151.86
No comparable office rate is available.
Stockton
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Vallejo
California · 32486
Office
Unavailable
Facility
$2209.26
No comparable office rate is available.
Visalia
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Yuba City
California · 32486
Office
Unavailable
Facility
$2077.32
No comparable office rate is available.
Colorado
Colorado · 32486
Office
Unavailable
Facility
$2143.00
No comparable office rate is available.
Connecticut
Connecticut · 32486
Office
Unavailable
Facility
$2310.89
No comparable office rate is available.
Fort Lauderdale
Florida · 32486
Office
Unavailable
Facility
$2466.34
No comparable office rate is available.
Rest Of Florida
Florida · 32486
Office
Unavailable
Facility
$2334.52
No comparable office rate is available.
Atlanta
Georgia · 32486
Office
Unavailable
Facility
$2257.92
No comparable office rate is available.
Rest Of Georgia
Georgia · 32486
Office
Unavailable
Facility
$2197.59
No comparable office rate is available.
Hawaii, Guam
Hawaii · 32486
Office
Unavailable
Facility
$2086.24
No comparable office rate is available.
Iowa
Iowa · 32486
Office
Unavailable
Facility
$1927.27
No comparable office rate is available.
Idaho
Idaho · 32486
Office
Unavailable
Facility
$1956.19
No comparable office rate is available.
East St. Louis
Illinois · 32486
Office
Unavailable
Facility
$2499.21
No comparable office rate is available.
Rest Of Illinois
Illinois · 32486
Office
Unavailable
Facility
$2337.29
No comparable office rate is available.
Suburban Chicago
Illinois · 32486
Office
Unavailable
Facility
$2469.42
No comparable office rate is available.
Indiana
Indiana · 32486
Office
Unavailable
Facility
$1963.76
No comparable office rate is available.
Kansas
Kansas · 32486
Office
Unavailable
Facility
$1960.28
No comparable office rate is available.
Kentucky
Kentucky · 32486
Office
Unavailable
Facility
$2098.70
No comparable office rate is available.
New Orleans
Louisiana · 32486
Office
Unavailable
Facility
$2198.79
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 32486
Office
Unavailable
Facility
$2112.14
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 32486
Office
Unavailable
Facility
$2277.44
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 32486
Office
Unavailable
Facility
$2149.52
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 32486
Office
Unavailable
Facility
$2313.11
No comparable office rate is available.
Rest Of Maryland
Maryland · 32486
Office
Unavailable
Facility
$2166.26
No comparable office rate is available.
Rest Of Maine
Maine · 32486
Office
Unavailable
Facility
$2008.69
No comparable office rate is available.
Southern Maine
Maine · 32486
Office
Unavailable
Facility
$2042.20
No comparable office rate is available.
Detroit
Michigan · 32486
Office
Unavailable
Facility
$2402.85
No comparable office rate is available.
Rest Of Michigan
Michigan · 32486
Office
Unavailable
Facility
$2184.36
No comparable office rate is available.
Minnesota
Minnesota · 32486
Office
Unavailable
Facility
$1940.38
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 32486
Office
Unavailable
Facility
$2141.90
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 32486
Office
Unavailable
Facility
$2156.27
No comparable office rate is available.
Rest Of Missouri
Missouri · 32486
Office
Unavailable
Facility
$2107.95
No comparable office rate is available.
Mississippi
Mississippi · 32486
Office
Unavailable
Facility
$2024.72
No comparable office rate is available.
Montana**
Montana · 32486
Office
Unavailable
Facility
$2175.36
No comparable office rate is available.
North Carolina
North Carolina · 32486
Office
Unavailable
Facility
$2020.24
No comparable office rate is available.
North Dakota**
North Dakota · 32486
Office
Unavailable
Facility
$1966.76
No comparable office rate is available.
Nebraska
Nebraska · 32486
Office
Unavailable
Facility
$1923.99
No comparable office rate is available.
New Hampshire
New Hampshire · 32486
Office
Unavailable
Facility
$2149.54
No comparable office rate is available.
Northern Nj
New Jersey · 32486
Office
Unavailable
Facility
$2356.36
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 32486
Office
Unavailable
Facility
$2305.41
No comparable office rate is available.
New Mexico
New Mexico · 32486
Office
Unavailable
Facility
$2211.44
No comparable office rate is available.
Nevada**
Nevada · 32486
Office
Unavailable
Facility
$2117.65
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 32486
Office
Unavailable
Facility
$2648.17
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 32486
Office
Unavailable
Facility
$2353.49
No comparable office rate is available.
Queens
New York · 32486
Office
Unavailable
Facility
$2498.95
No comparable office rate is available.
Rest Of New York
New York · 32486
Office
Unavailable
Facility
$2050.05
No comparable office rate is available.
Ohio
Ohio · 32486
Office
Unavailable
Facility
$2141.72
No comparable office rate is available.
Oklahoma
Oklahoma · 32486
Office
Unavailable
Facility
$2051.78
No comparable office rate is available.
Portland
Oregon · 32486
Office
Unavailable
Facility
$2155.62
No comparable office rate is available.
Rest Of Oregon
Oregon · 32486
Office
Unavailable
Facility
$2069.70
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 32486
Office
Unavailable
Facility
$2286.73
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 32486
Office
Unavailable
Facility
$2121.66
No comparable office rate is available.
Puerto Rico
Puerto Rico · 32486
Office
Unavailable
Facility
$2175.48
No comparable office rate is available.
Rhode Island
Rhode Island · 32486
Office
Unavailable
Facility
$2178.64
No comparable office rate is available.
South Carolina
South Carolina · 32486
Office
Unavailable
Facility
$2090.74
No comparable office rate is available.
South Dakota**
South Dakota · 32486
Office
Unavailable
Facility
$1942.09
No comparable office rate is available.
Tennessee
Tennessee · 32486
Office
Unavailable
Facility
$1974.04
No comparable office rate is available.
Austin
Texas · 32486
Office
Unavailable
Facility
$2163.47
No comparable office rate is available.
Beaumont
Texas · 32486
Office
Unavailable
Facility
$2112.60
No comparable office rate is available.
Brazoria
Texas · 32486
Office
Unavailable
Facility
$2105.87
No comparable office rate is available.
Dallas
Texas · 32486
Office
Unavailable
Facility
$2136.89
No comparable office rate is available.
Fort Worth
Texas · 32486
Office
Unavailable
Facility
$2137.20
No comparable office rate is available.
Galveston
Texas · 32486
Office
Unavailable
Facility
$2123.64
No comparable office rate is available.
Houston
Texas · 32486
Office
Unavailable
Facility
$2316.74
No comparable office rate is available.
Rest Of Texas
Texas · 32486
Office
Unavailable
Facility
$2120.10
No comparable office rate is available.
Utah
Utah · 32486
Office
Unavailable
Facility
$2114.49
No comparable office rate is available.
Virginia
Virginia · 32486
Office
Unavailable
Facility
$2065.21
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 32486
Office
Unavailable
Facility
$2175.48
No comparable office rate is available.
Vermont
Vermont · 32486
Office
Unavailable
Facility
$1997.72
No comparable office rate is available.
Rest Of Washington
Washington · 32486
Office
Unavailable
Facility
$2132.65
No comparable office rate is available.
Seattle (King Cnty)
Washington · 32486
Office
Unavailable
Facility
$2278.38
No comparable office rate is available.
Wisconsin
Wisconsin · 32486
Office
Unavailable
Facility
$1914.28
No comparable office rate is available.
West Virginia
West Virginia · 32486
Office
Unavailable
Facility
$2271.98
No comparable office rate is available.
Wyoming**
Wyoming · 32486
Office
Unavailable
Facility
$2084.45
No comparable office rate is available.
See how rates vary across the country
32486 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 32486 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2356.56
$2142.33 × 110% = $2356.56
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 32486 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
3,718
- Code
- 32486
- Physician work
- 41.81
- Practice expense
- 12.79
- Malpractice
- 10.55
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 41.81 | × 1.005 | 42.0191 |
| Practice expense | 12.79 | × 0.988 | 12.6365 |
| Malpractice | 10.55 | × 0.899 | 9.4845 |
| Total RVUs | 64.1400 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$2142.33
Open 32486 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 41.81 | 1.005 |
| Practice expense | 12.79 | 0.988 |
| Malpractice | 10.55 | 0.899 |
(41.81 × 1.005 + 12.79 × 0.988 + 10.55 × 0.899) × $33.4009 = $2142.33
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
32486 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2142.33 | RVU26D |
| 2026-07-01 | Not available in this setting | $2142.33 | RVU26C |
| 2026-04-01 | Not available in this setting | $2142.33 | RVU26B |
| 2026-01-01 | Not available in this setting | $2142.33 | RVU26A |
| 2025-10-01 | Not available in this setting | $2225.92 | RVU25D |
| 2025-07-01 | Not available in this setting | $2225.92 | RVU25C |
| 2025-04-01 | Not available in this setting | $2225.92 | RVU25B |
| 2025-01-01 | Not available in this setting | $2225.92 | RVU25A |
32486 billing questions
When should 32486 be chosen instead of a conventional lobectomy code?
Choose 32486 when the operation includes resection of the involved bronchus and reconstruction of the airway along with removal of a lung lobe. A lobectomy without that bronchial sleeve work is not this service.
Is bronchial reconstruction separately reported with 32486?
The bronchial sleeve resection and reconstruction are part of the combined service represented by 32486. Do not treat that reconstruction as a separate service from the sleeve lobectomy.
How does 32486 differ from sleeve pneumonectomy 32442?
A sleeve lobectomy removes a lobe and reconstructs the airway while preserving the remaining lung. Sleeve pneumonectomy involves removal of the entire lung with airway reconstruction.
Can modifier 50 be used for a sleeve lobectomy?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
What documentation supports reporting 32486?
The operative report should show the lobe removed, the bronchial portion resected, and the airway reconstruction. It should distinguish the operation from a lobectomy without bronchial sleeve work.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
