$742.27
Choose 32557 when imaging guides the percutaneous catheter placement. Choose 32556 when the same type of placement is performed without imaging guidance.
On this page
CMS RVU26D · Effective 2026-10-01
32557 Pleural catheter Medicare reimbursement rates in Alabama
Report percutaneous placement of an indwelling pleural catheter with imaging guidance to drain pleural fluid or air, such as an effusion or pneumothorax. Compare 32557 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 32557 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$576.27
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$122.39
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Pulmonary procedures
About 32557: Percutaneous pleural catheter placement with imaging
Report percutaneous placement of an indwelling pleural catheter with imaging guidance to drain pleural fluid or air, such as an effusion or pneumothorax.
A clinician places a catheter through the chest wall into the pleural space using imaging to guide its position. The catheter remains in place to drain pleural fluid or air; common situations include a pleural effusion, empyema, or pneumothorax. The service is typically performed by a pulmonologist, interventional radiologist, or other clinician experienced in image-guided pleural procedures, often in a hospital or outpatient procedural setting. Imaging guidance is part of this service, rather than a separate placement without guidance.
Report this code when the procedure documents percutaneous catheter placement and imaging guidance; distinguish it from a one-time pleural aspiration and from placement by an open approach. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 32557
- 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 RVU3.04 · 16%
- Practice expense (office) RVU16.03 · 83%
- Malpractice RVU0.33 · 2%
31.8K
Medicare services in 2024 · #950 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.
32557 compared with similar codes
Office rates for Alabama, from the same CMS release.
$279.05
32555 is pleural aspiration with imaging guidance; 32557 involves placing an indwelling catheter for drainage.
$696.32
32550 describes tunneled pleural catheter placement. 32557 describes percutaneous catheter placement with imaging guidance, not a tunneled catheter service.
No office rate
32551 is chest tube insertion through an open approach. Use 32557 for percutaneous catheter placement with imaging guidance.
Compare 32557 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$576.27
Facility
$122.39
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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 32557 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
3,736
- Code
- 32557
- Physician work
- 3.04
- Practice expense
- 16.03
- Malpractice
- 0.33
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.04 | × 1.000 | 3.0400 |
| Practice expense | 16.03 | × 0.875 | 14.0263 |
| Malpractice | 0.33 | × 0.566 | 0.1868 |
| Total RVUs | 17.2530 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$576.27
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.04 | 1 |
| Practice expense | 16.03 | 0.875 |
| Malpractice | 0.33 | 0.566 |
(3.04 × 1 + 16.03 × 0.875 + 0.33 × 0.566) × $33.4009 = $576.27
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.04 | 1 |
| Practice expense | 0.5 | 0.875 |
| Malpractice | 0.33 | 0.566 |
(3.04 × 1 + 0.5 × 0.875 + 0.33 × 0.566) × $33.4009 = $122.39
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.
32557 billing questions
How does this differ from 32556?
Both describe percutaneous placement of an indwelling pleural catheter. Use 32557 when imaging guidance is used; 32556 is the corresponding service without imaging guidance.
Can imaging guidance be billed separately?
Imaging guidance is included in 32557. Do not separately report guidance for the same catheter placement.
When is 32555 more appropriate?
32555 describes pleural aspiration with imaging guidance, rather than placement of a catheter that remains in the pleural space for drainage.
How is bilateral placement reported?
Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports 32557?
Document the indication, percutaneous catheter placement into the pleural space, use of imaging guidance, and the catheter’s placement and intended drainage.
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.
3,73332554,,Aspirate pleura w/o imaging,A,,1.77,5.82,,0.39,,0.21,7.80,2.37,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73432555,,Aspirate pleura w/ imaging,A,,2.21,6.88,,0.38,,0.22,9.31,2.81,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73532556,,Insert cath pleura w/o image,A,,2.44,22.37,,0.54,,0.37,25.18,3.35,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73632557,,Insert cath pleura w/ image,A,,3.04,16.03,,0.50,,0.33,19.40,3.87,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73732560,,Treat pleurodesis w/agent,A,,1.50,6.54,,0.32,,0.23,8.27,2.05,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73832561,,Lyse chest fibrin init day,A,,1.36,1.52,,0.29,,0.15,3.03,1.80,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73932562,,Lyse chest fibrin subq day,A,,1.21,1.41,,0.27,,0.13,2.75,1.61,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515