32999
No office rateUnlisted px lungs & pleura
Use 32997 when the service is whole-lung lavage. Consider 32999 only when the lung or pleural procedure performed is not accurately represented by a specific listed code.
On this page
CMS RVU26D · Effective 2026-10-01
32997 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$295.15
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.
Pulmonary procedure
About 32997: Therapeutic total lung lavage
Reports therapeutic washing of an entire lung, typically for pulmonary alveolar proteinosis, using repeated saline instillation and drainage.
Total lung lavage washes an entire lung to remove accumulated material from the air spaces, most commonly in a patient with pulmonary alveolar proteinosis. In a controlled operating-room setting, the lung being treated is isolated while the other lung is ventilated; warmed saline is introduced and drained in repeated cycles. A thoracic surgeon or pulmonologist typically performs the lavage with anesthesia support. The procedure treats a whole lung rather than a focal lesion or an individual airway.
Report the service when the operative record supports therapeutic lavage of the entire lung, including the indication, side treated, lung-isolation approach, and lavage performed. For bilateral treatment, CMS recognizes modifier 50 and pays the bilateral procedure at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 32997
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.13 · 79%
- Practice expense (office) RVU1.27 · 14%
- Malpractice RVU0.59 · 7%
64
Medicare services in 2024 · #5197 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.
32997 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
$132.97
32960 describes therapeutic pneumothorax. It does not represent saline washing and drainage of an entire lung.
$4,535.84
32994 describes percutaneous cryoablation of a pulmonary tumor. It targets a focal tumor rather than washing an entire lung.
$2,913.72
32998 describes percutaneous radiofrequency ablation of a pulmonary tumor. Use 32997 for therapeutic whole-lung lavage, not focal tumor ablation.
The same code, a different location
How does Wyoming** compare?
32997 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · 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 Wyoming 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 · 32997
Office
Unavailable
Facility
$286.42
No comparable office rate is available.
Arkansas
Arkansas · 32997
Office
Unavailable
Facility
$284.74
No comparable office rate is available.
Arizona
Arizona · 32997
Office
Unavailable
Facility
$296.12
No comparable office rate is available.
Bakersfield
California · 32997
Office
Unavailable
Facility
$301.17
No comparable office rate is available.
Chico
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
El Centro
California · 32997
Office
Unavailable
Facility
$299.35
No comparable office rate is available.
Fresno
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Hanford-Corcoran
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Madera
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Merced
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Modesto
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Napa
California · 32997
Office
Unavailable
Facility
$319.07
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 32997
Office
Unavailable
Facility
$307.23
No comparable office rate is available.
Redding
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Rest Of California
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 32997
Office
Unavailable
Facility
$305.74
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 32997
Office
Unavailable
Facility
$306.62
No comparable office rate is available.
Salinas
California · 32997
Office
Unavailable
Facility
$305.26
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 32997
Office
Unavailable
Facility
$306.71
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 32997
Office
Unavailable
Facility
$329.63
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 32997
Office
Unavailable
Facility
$328.96
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 32997
Office
Unavailable
Facility
$336.08
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 32997
Office
Unavailable
Facility
$333.34
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 32997
Office
Unavailable
Facility
$301.08
No comparable office rate is available.
Santa Cruz-Watsonville
California · 32997
Office
Unavailable
Facility
$305.25
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 32997
Office
Unavailable
Facility
$304.84
No comparable office rate is available.
Santa Rosa-Petaluma
California · 32997
Office
Unavailable
Facility
$307.95
No comparable office rate is available.
Stockton
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Vallejo
California · 32997
Office
Unavailable
Facility
$318.11
No comparable office rate is available.
Visalia
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Yuba City
California · 32997
Office
Unavailable
Facility
$299.25
No comparable office rate is available.
Colorado
Colorado · 32997
Office
Unavailable
Facility
$301.53
No comparable office rate is available.
Connecticut
Connecticut · 32997
Office
Unavailable
Facility
$312.44
No comparable office rate is available.
Delaware
Delaware · 32997
Office
Unavailable
Facility
$298.97
No comparable office rate is available.
Fort Lauderdale
Florida · 32997
Office
Unavailable
Facility
$316.75
No comparable office rate is available.
Rest Of Florida
Florida · 32997
Office
Unavailable
Facility
$308.32
No comparable office rate is available.
Atlanta
Georgia · 32997
Office
Unavailable
Facility
$305.63
No comparable office rate is available.
Rest Of Georgia
Georgia · 32997
Office
Unavailable
Facility
$299.48
No comparable office rate is available.
Hawaii, Guam
Hawaii · 32997
Office
Unavailable
Facility
$297.79
No comparable office rate is available.
Iowa
Iowa · 32997
Office
Unavailable
Facility
$284.79
No comparable office rate is available.
Idaho
Idaho · 32997
Office
Unavailable
Facility
$286.50
No comparable office rate is available.
East St. Louis
Illinois · 32997
Office
Unavailable
Facility
$316.86
No comparable office rate is available.
Rest Of Illinois
Illinois · 32997
Office
Unavailable
Facility
$307.68
No comparable office rate is available.
Suburban Chicago
Illinois · 32997
Office
Unavailable
Facility
$318.30
No comparable office rate is available.
Indiana
Indiana · 32997
Office
Unavailable
Facility
$287.05
No comparable office rate is available.
Kansas
Kansas · 32997
Office
Unavailable
Facility
$286.43
No comparable office rate is available.
Kentucky
Kentucky · 32997
Office
Unavailable
Facility
$293.89
No comparable office rate is available.
New Orleans
Louisiana · 32997
Office
Unavailable
Facility
$300.45
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 32997
Office
Unavailable
Facility
$294.57
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 32997
Office
Unavailable
Facility
$316.10
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 32997
Office
Unavailable
Facility
$302.33
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 32997
Office
Unavailable
Facility
$311.85
No comparable office rate is available.
Rest Of Maryland
Maryland · 32997
Office
Unavailable
Facility
$301.55
No comparable office rate is available.
Rest Of Maine
Maine · 32997
Office
Unavailable
Facility
$289.43
No comparable office rate is available.
Southern Maine
Maine · 32997
Office
Unavailable
Facility
$292.62
No comparable office rate is available.
Detroit
Michigan · 32997
Office
Unavailable
Facility
$312.31
No comparable office rate is available.
Rest Of Michigan
Michigan · 32997
Office
Unavailable
Facility
$299.13
No comparable office rate is available.
Minnesota
Minnesota · 32997
Office
Unavailable
Facility
$287.63
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 32997
Office
Unavailable
Facility
$297.23
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 32997
Office
Unavailable
Facility
$298.28
No comparable office rate is available.
Rest Of Missouri
Missouri · 32997
Office
Unavailable
Facility
$293.91
No comparable office rate is available.
Mississippi
Mississippi · 32997
Office
Unavailable
Facility
$289.23
No comparable office rate is available.
Montana**
Montana · 32997
Office
Unavailable
Facility
$300.23
No comparable office rate is available.
North Carolina
North Carolina · 32997
Office
Unavailable
Facility
$290.32
No comparable office rate is available.
North Dakota**
North Dakota · 32997
Office
Unavailable
Facility
$288.57
No comparable office rate is available.
Nebraska
Nebraska · 32997
Office
Unavailable
Facility
$284.75
No comparable office rate is available.
New Hampshire
New Hampshire · 32997
Office
Unavailable
Facility
$299.55
No comparable office rate is available.
Northern Nj
New Jersey · 32997
Office
Unavailable
Facility
$323.40
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 32997
Office
Unavailable
Facility
$315.61
No comparable office rate is available.
New Mexico
New Mexico · 32997
Office
Unavailable
Facility
$300.71
No comparable office rate is available.
Nevada**
Nevada · 32997
Office
Unavailable
Facility
$297.03
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 32997
Office
Unavailable
Facility
$340.42
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 32997
Office
Unavailable
Facility
$319.16
No comparable office rate is available.
Queens
New York · 32997
Office
Unavailable
Facility
$331.95
No comparable office rate is available.
Rest Of New York
New York · 32997
Office
Unavailable
Facility
$292.30
No comparable office rate is available.
Ohio
Ohio · 32997
Office
Unavailable
Facility
$296.74
No comparable office rate is available.
Oklahoma
Oklahoma · 32997
Office
Unavailable
Facility
$291.34
No comparable office rate is available.
Portland
Oregon · 32997
Office
Unavailable
Facility
$303.75
No comparable office rate is available.
Rest Of Oregon
Oregon · 32997
Office
Unavailable
Facility
$294.25
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 32997
Office
Unavailable
Facility
$310.10
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 32997
Office
Unavailable
Facility
$295.71
No comparable office rate is available.
Puerto Rico
Puerto Rico · 32997
Office
Unavailable
Facility
$300.45
No comparable office rate is available.
Rhode Island
Rhode Island · 32997
Office
Unavailable
Facility
$304.07
No comparable office rate is available.
South Carolina
South Carolina · 32997
Office
Unavailable
Facility
$294.09
No comparable office rate is available.
South Dakota**
South Dakota · 32997
Office
Unavailable
Facility
$287.19
No comparable office rate is available.
Tennessee
Tennessee · 32997
Office
Unavailable
Facility
$287.29
No comparable office rate is available.
Austin
Texas · 32997
Office
Unavailable
Facility
$300.96
No comparable office rate is available.
Beaumont
Texas · 32997
Office
Unavailable
Facility
$295.06
No comparable office rate is available.
Brazoria
Texas · 32997
Office
Unavailable
Facility
$297.46
No comparable office rate is available.
Dallas
Texas · 32997
Office
Unavailable
Facility
$299.45
No comparable office rate is available.
Fort Worth
Texas · 32997
Office
Unavailable
Facility
$299.28
No comparable office rate is available.
Galveston
Texas · 32997
Office
Unavailable
Facility
$298.49
No comparable office rate is available.
Houston
Texas · 32997
Office
Unavailable
Facility
$309.29
No comparable office rate is available.
Rest Of Texas
Texas · 32997
Office
Unavailable
Facility
$296.20
No comparable office rate is available.
Utah
Utah · 32997
Office
Unavailable
Facility
$295.72
No comparable office rate is available.
Virginia
Virginia · 32997
Office
Unavailable
Facility
$293.76
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 32997
Office
Unavailable
Facility
$300.45
No comparable office rate is available.
Vermont
Vermont · 32997
Office
Unavailable
Facility
$290.11
No comparable office rate is available.
Rest Of Washington
Washington · 32997
Office
Unavailable
Facility
$300.91
No comparable office rate is available.
Seattle (King Cnty)
Washington · 32997
Office
Unavailable
Facility
$318.20
No comparable office rate is available.
Wisconsin
Wisconsin · 32997
Office
Unavailable
Facility
$284.86
No comparable office rate is available.
West Virginia
West Virginia · 32997
Office
Unavailable
Facility
$303.21
No comparable office rate is available.
See how rates vary across the country
32997 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 32997 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$324.66
$295.15 × 110% = $324.66
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 32997 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,810
- Code
- 32997
- Physician work
- 7.13
- Practice expense
- 1.27
- Malpractice
- 0.59
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.13 | × 1.000 | 7.1300 |
| Practice expense | 1.27 | × 1.000 | 1.2700 |
| Malpractice | 0.59 | × 0.740 | 0.4366 |
| Total RVUs | 8.8366 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$295.15
Open 32997 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.13 | 1 |
| Practice expense | 1.27 | 1 |
| Malpractice | 0.59 | 0.74 |
(7.13 × 1 + 1.27 × 1 + 0.59 × 0.74) × $33.4009 = $295.15
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
32997 · 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 | $295.15 | RVU26D |
| 2026-07-01 | Not available in this setting | $295.15 | RVU26C |
| 2026-04-01 | Not available in this setting | $295.15 | RVU26B |
| 2026-01-01 | Not available in this setting | $295.15 | RVU26A |
| 2025-10-01 | Not available in this setting | $315.01 | RVU25D |
| 2025-07-01 | Not available in this setting | $315.01 | RVU25C |
| 2025-04-01 | Not available in this setting | $315.01 | RVU25B |
| 2025-01-01 | Not available in this setting | $315.01 | RVU25A |
32997 billing questions
When is 32997 appropriate instead of a lung tumor ablation code?
Use 32997 for therapeutic washing of an entire lung, typically for pulmonary alveolar proteinosis. Lung tumor ablation codes describe treatment directed at a focal tumor, not diffuse material in the air spaces.
How should bilateral lavage be reported?
When both lungs are treated, report the bilateral service with modifier 50. CMS pays the bilateral procedure at 150%.
What documentation supports 32997?
Document the therapeutic indication, the side or sides treated, lung isolation, and the lavage performed. The record should make clear that the service involved whole-lung washing rather than a focal airway or tumor procedure.
How does the multiple-procedure reduction affect 32997?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and other procedures at 50%. Which procedure receives the reduction depends on the relative values of the services reported.
Can an assistant or co-surgeon be reported for this procedure?
Medicare does not pay an assistant at surgery for 32997. Co-surgeons and team surgery are not permitted.
What care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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.
3,8073294F,,Grp b strep screening docd,I,,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
3,80832960,,Therapeutic pneumothorax,A,,1.79,2.08,,0.52,,0.15,4.02,2.46,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,80932994,,Ablate pulm tumor perq crybl,A,,8.80,126.26,,1.60,,1.00,136.06,11.40,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81032997,,Total lung lavage,A,,7.13,1.27,NA,1.27,,0.59,8.99,8.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81132998,,Ablate pulm tumor perq rf,A,,8.80,77.68,,1.58,,1.02,87.50,11.40,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81232999,,Unlisted px lungs & pleura,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8133300F,,Ajcc stage docd b/4 thxpy,I,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,