$294.48
Code 32560 describes chemical pleurodesis through a chest tube. Use 32650 when the pleurodesis is performed with a thoracoscopic approach.
On this page
CMS RVU26D · Effective 2026-10-01
32650 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$637.00
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 32650: Thoracoscopic pleurodesis
Thoracoscopic pleurodesis creates adhesion between pleural surfaces, commonly to reduce recurrence of pneumothorax or manage recurrent pleural effusion.
A thoracic surgeon performs this operation through a thoracoscope to make the visceral and parietal pleura adhere, using a mechanical or chemical technique. Common situations include recurrent pneumothorax and recurrent pleural effusion, including effusion associated with malignancy. The service is typically performed in an operating room or hospital setting under general anesthesia.
Report the code for the thoracoscopic pleurodesis itself, with the operative report identifying the indication, approach, and method used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. For a bilateral procedure reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32650
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU10.56 · 54%
- Practice expense (office) RVU6.35 · 33%
- Malpractice RVU2.56 · 13%
3.8K
Medicare services in 2024 · #2030 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.
32650 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
Code 32609 represents thoracoscopic pleural biopsy. It describes diagnostic tissue sampling, not pleural adhesion treatment.
No office rate
Code 32656 describes thoracoscopic pleurectomy, which removes pleural tissue. Code 32650 is for creating pleural adhesion without coding the service as pleurectomy.
The same code, a different location
How does Modesto compare?
32650 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
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.
No comparable rate is available in this setting.
Other payment areas listed in California 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
Madera
California · 32650
Office
Unavailable
Facility
$637.00
No comparable office rate is available.
Merced
California · 32650
Office
Unavailable
Facility
$637.00
No comparable office rate is available.
Napa
California · 32650
Office
Unavailable
Facility
$697.91
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 32650
Office
Unavailable
Facility
$666.56
No comparable office rate is available.
Redding
California · 32650
Office
Unavailable
Facility
$637.00
No comparable office rate is available.
Rest Of California
California · 32650
Office
Unavailable
Facility
$637.00
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 32650
Office
Unavailable
Facility
$664.46
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 32650
Office
Unavailable
Facility
$657.91
No comparable office rate is available.
Salinas
California · 32650
Office
Unavailable
Facility
$655.30
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 32650
Office
Unavailable
Facility
$663.31
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 32650
Office
Unavailable
Facility
$724.52
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 32650
Office
Unavailable
Facility
$721.62
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 32650
Office
Unavailable
Facility
$743.19
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 32650
Office
Unavailable
Facility
$731.30
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 32650
Office
Unavailable
Facility
$646.12
No comparable office rate is available.
Santa Cruz-Watsonville
California · 32650
Office
Unavailable
Facility
$663.65
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 32650
Office
Unavailable
Facility
$655.72
No comparable office rate is available.
Santa Rosa-Petaluma
California · 32650
Office
Unavailable
Facility
$669.58
No comparable office rate is available.
Stockton
California · 32650
Office
Unavailable
Facility
$637.00
No comparable office rate is available.
Vallejo
California · 32650
Office
Unavailable
Facility
$693.72
No comparable office rate is available.
Visalia
California · 32650
Office
Unavailable
Facility
$637.00
No comparable office rate is available.
Yuba City
California · 32650
Office
Unavailable
Facility
$637.00
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 32650
Office
Unavailable
Facility
$716.78
No comparable office rate is available.
Miami
Florida · 32650
Office
Unavailable
Facility
$789.75
No comparable office rate is available.
Chicago
Illinois · 32650
Office
Unavailable
Facility
$764.58
No comparable office rate is available.
Manhattan
New York · 32650
Office
Unavailable
Facility
$757.36
No comparable office rate is available.
Alaska*
Alaska · 32650
Office
Unavailable
Facility
$802.07
No comparable office rate is available.
Alabama
Alabama · 32650
Office
Unavailable
Facility
$586.69
No comparable office rate is available.
Arkansas
Arkansas · 32650
Office
Unavailable
Facility
$578.94
No comparable office rate is available.
Arizona
Arizona · 32650
Office
Unavailable
Facility
$631.43
No comparable office rate is available.
Colorado
Colorado · 32650
Office
Unavailable
Facility
$649.40
No comparable office rate is available.
Connecticut
Connecticut · 32650
Office
Unavailable
Facility
$691.66
No comparable office rate is available.
Delaware
Delaware · 32650
Office
Unavailable
Facility
$640.90
No comparable office rate is available.
Fort Lauderdale
Florida · 32650
Office
Unavailable
Facility
$722.16
No comparable office rate is available.
Rest Of Florida
Florida · 32650
Office
Unavailable
Facility
$683.99
No comparable office rate is available.
Atlanta
Georgia · 32650
Office
Unavailable
Facility
$671.95
No comparable office rate is available.
Rest Of Georgia
Georgia · 32650
Office
Unavailable
Facility
$643.83
No comparable office rate is available.
Hawaii, Guam
Hawaii · 32650
Office
Unavailable
Facility
$643.37
No comparable office rate is available.
Iowa
Iowa · 32650
Office
Unavailable
Facility
$580.73
No comparable office rate is available.
Idaho
Idaho · 32650
Office
Unavailable
Facility
$588.29
No comparable office rate is available.
East St. Louis
Illinois · 32650
Office
Unavailable
Facility
$720.05
No comparable office rate is available.
Rest Of Illinois
Illinois · 32650
Office
Unavailable
Facility
$680.00
No comparable office rate is available.
Suburban Chicago
Illinois · 32650
Office
Unavailable
Facility
$724.52
No comparable office rate is available.
Indiana
Indiana · 32650
Office
Unavailable
Facility
$590.88
No comparable office rate is available.
Kansas
Kansas · 32650
Office
Unavailable
Facility
$587.54
No comparable office rate is available.
Kentucky
Kentucky · 32650
Office
Unavailable
Facility
$619.50
No comparable office rate is available.
New Orleans
Louisiana · 32650
Office
Unavailable
Facility
$649.43
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 32650
Office
Unavailable
Facility
$622.33
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 32650
Office
Unavailable
Facility
$696.52
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 32650
Office
Unavailable
Facility
$649.84
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 32650
Office
Unavailable
Facility
$691.71
No comparable office rate is available.
Rest Of Maryland
Maryland · 32650
Office
Unavailable
Facility
$649.38
No comparable office rate is available.
Rest Of Maine
Maine · 32650
Office
Unavailable
Facility
$601.03
No comparable office rate is available.
Southern Maine
Maine · 32650
Office
Unavailable
Facility
$616.85
No comparable office rate is available.
Detroit
Michigan · 32650
Office
Unavailable
Facility
$701.55
No comparable office rate is available.
Rest Of Michigan
Michigan · 32650
Office
Unavailable
Facility
$642.89
No comparable office rate is available.
Minnesota
Minnesota · 32650
Office
Unavailable
Facility
$596.27
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 32650
Office
Unavailable
Facility
$635.41
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 32650
Office
Unavailable
Facility
$640.31
No comparable office rate is available.
Rest Of Missouri
Missouri · 32650
Office
Unavailable
Facility
$618.82
No comparable office rate is available.
Mississippi
Mississippi · 32650
Office
Unavailable
Facility
$598.52
No comparable office rate is available.
Montana**
Montana · 32650
Office
Unavailable
Facility
$650.14
No comparable office rate is available.
North Carolina
North Carolina · 32650
Office
Unavailable
Facility
$605.24
No comparable office rate is available.
North Dakota**
North Dakota · 32650
Office
Unavailable
Facility
$599.52
No comparable office rate is available.
Nebraska
Nebraska · 32650
Office
Unavailable
Facility
$580.80
No comparable office rate is available.
New Hampshire
New Hampshire · 32650
Office
Unavailable
Facility
$648.32
No comparable office rate is available.
Northern Nj
New Jersey · 32650
Office
Unavailable
Facility
$712.29
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 32650
Office
Unavailable
Facility
$692.23
No comparable office rate is available.
New Mexico
New Mexico · 32650
Office
Unavailable
Facility
$649.90
No comparable office rate is available.
Nevada**
Nevada · 32650
Office
Unavailable
Facility
$636.25
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 32650
Office
Unavailable
Facility
$786.25
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 32650
Office
Unavailable
Facility
$704.29
No comparable office rate is available.
Queens
New York · 32650
Office
Unavailable
Facility
$749.28
No comparable office rate is available.
Rest Of New York
New York · 32650
Office
Unavailable
Facility
$614.32
No comparable office rate is available.
Ohio
Ohio · 32650
Office
Unavailable
Facility
$632.55
No comparable office rate is available.
Oklahoma
Oklahoma · 32650
Office
Unavailable
Facility
$608.55
No comparable office rate is available.
Portland
Oregon · 32650
Office
Unavailable
Facility
$657.61
No comparable office rate is available.
Rest Of Oregon
Oregon · 32650
Office
Unavailable
Facility
$624.07
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 32650
Office
Unavailable
Facility
$681.86
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 32650
Office
Unavailable
Facility
$628.22
No comparable office rate is available.
Puerto Rico
Puerto Rico · 32650
Office
Unavailable
Facility
$651.37
No comparable office rate is available.
Rhode Island
Rhode Island · 32650
Office
Unavailable
Facility
$654.78
No comparable office rate is available.
South Carolina
South Carolina · 32650
Office
Unavailable
Facility
$621.37
No comparable office rate is available.
South Dakota**
South Dakota · 32650
Office
Unavailable
Facility
$593.54
No comparable office rate is available.
Tennessee
Tennessee · 32650
Office
Unavailable
Facility
$591.43
No comparable office rate is available.
Austin
Texas · 32650
Office
Unavailable
Facility
$653.57
No comparable office rate is available.
Beaumont
Texas · 32650
Office
Unavailable
Facility
$625.16
No comparable office rate is available.
Brazoria
Texas · 32650
Office
Unavailable
Facility
$632.42
No comparable office rate is available.
Dallas
Texas · 32650
Office
Unavailable
Facility
$640.50
No comparable office rate is available.
Fort Worth
Texas · 32650
Office
Unavailable
Facility
$639.49
No comparable office rate is available.
Galveston
Texas · 32650
Office
Unavailable
Facility
$636.95
No comparable office rate is available.
Houston
Texas · 32650
Office
Unavailable
Facility
$683.80
No comparable office rate is available.
Rest Of Texas
Texas · 32650
Office
Unavailable
Facility
$631.20
No comparable office rate is available.
Utah
Utah · 32650
Office
Unavailable
Facility
$628.87
No comparable office rate is available.
Virginia
Virginia · 32650
Office
Unavailable
Facility
$621.57
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 32650
Office
Unavailable
Facility
$651.37
No comparable office rate is available.
Vermont
Vermont · 32650
Office
Unavailable
Facility
$605.95
No comparable office rate is available.
Rest Of Washington
Washington · 32650
Office
Unavailable
Facility
$645.71
No comparable office rate is available.
Seattle (King Cnty)
Washington · 32650
Office
Unavailable
Facility
$700.45
No comparable office rate is available.
Wisconsin
Wisconsin · 32650
Office
Unavailable
Facility
$582.24
No comparable office rate is available.
West Virginia
West Virginia · 32650
Office
Unavailable
Facility
$659.38
No comparable office rate is available.
Wyoming**
Wyoming · 32650
Office
Unavailable
Facility
$628.08
No comparable office rate is available.
See how rates vary across the country
32650 · 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?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, 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 32650 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$700.70
$637.00 × 110% = $700.70
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 32650 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
3,747
- Code
- 32650
- Physician work
- 10.56
- Practice expense
- 6.35
- Malpractice
- 2.56
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.56 | × 1.017 | 10.7395 |
| Practice expense | 6.35 | × 1.096 | 6.9596 |
| Malpractice | 2.56 | × 0.536 | 1.3722 |
| Total RVUs | 19.0713 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$637.00
Open 32650 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.56 | 1.017 |
| Practice expense | 6.35 | 1.096 |
| Malpractice | 2.56 | 0.536 |
(10.56 × 1.017 + 6.35 × 1.096 + 2.56 × 0.536) × $33.4009 = $637.00
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
32650 · 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 | $637.00 | RVU26D |
| 2026-07-01 | Not available in this setting | $637.00 | RVU26C |
| 2026-04-01 | Not available in this setting | $637.00 | RVU26B |
| 2026-01-01 | Not available in this setting | $637.00 | RVU26A |
| 2025-10-01 | Not available in this setting | $635.09 | RVU25D |
| 2025-07-01 | Not available in this setting | $635.09 | RVU25C |
| 2025-04-01 | Not available in this setting | $635.09 | RVU25B |
| 2025-01-01 | Not available in this setting | $635.09 | RVU25A |
32650 billing questions
When should I report this instead of code 32560?
Report this code when pleurodesis is performed thoracoscopically. Code 32560 describes chemical pleurodesis delivered through a chest tube without a thoracoscopic approach.
How does this differ from thoracoscopic pleurectomy?
Pleurodesis brings the pleural surfaces together to form an adhesion. Pleurectomy removes pleural tissue and is a different operative approach.
Can a pleural biopsy be reported during the same operation?
A pleural biopsy may be performed for diagnostic evaluation during the encounter. Documentation should identify the biopsy site and its separate purpose; apply applicable coding edits when reporting both services.
What does the 90-day global period include?
It includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
How is bilateral pleurodesis handled under the CMS payment facts?
For a bilateral procedure reported with modifier 50, CMS pays at 150%.
May an assistant surgeon be paid for this operation?
CMS permits assistant-at-surgery payment. Co-surgeon payment requires 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 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.
3,74432608,,Thoracoscopy w/bx nodule,A,,6.67,2.23,NA,2.23,,1.67,10.57,10.57,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74532609,,Thoracoscopy w/bx pleura,A,,4.47,1.73,NA,1.73,,0.95,7.15,7.15,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,7463260F,,Pt cat/pn cat/hist grd docd,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74732650,,Thoracoscopy w/pleurodesis,A,,10.56,6.35,NA,6.35,,2.56,19.47,19.47,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74832651,,Thoracoscopy remove cortex,A,,18.31,8.27,NA,8.27,,4.55,31.13,31.13,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74932652,,Thoracoscopy rem totl cortex,A,,28.40,11.49,NA,11.49,,7.11,47.00,47.00,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75032653,,Thoracoscopy remov fb/fibrin,A,,17.72,8.18,NA,8.18,,4.23,30.13,30.13,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536