No office rate
32651 represents partial pulmonary decortication; 32652 is the corresponding code when the surgeon performs total decortication.
On this page
CMS RVU26D · Effective 2026-10-01
32651 Thoracoscopic decortication Medicare reimbursement rates in Alaska
Thoracoscopic partial lung decortication removes a restrictive pleural peel to free the lung, commonly during operative treatment of organized empyema or fibrothorax. Compare 32651 office and facility rates across CMS payment localities in Alaska.
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 32651 in Alaska?
Alaska 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
No supported rate
Facility setting
$1295.27
1 of 1 localities have a supported rate.
Payment area: Alaska*
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.
Thoracic surgery
About 32651: Thoracoscopic partial lung decortication
Thoracoscopic partial lung decortication removes a restrictive pleural peel to free the lung, commonly during operative treatment of organized empyema or fibrothorax.
A thoracic surgeon uses thoracoscopy to remove part of a fibrous peel restricting lung expansion. The operation may be performed for organized empyema or fibrothorax when pleural scarring limits re-expansion. It is typically done in a hospital operating room, often with the patient under general anesthesia. The operative report should describe the pleural disease, the area treated, and the extent of decortication performed.
Report this code when the surgeon performs partial pulmonary decortication, not merely pleural inspection, biopsy, or removal of loose material. The documented extent distinguishes partial decortication from total decortication, reported with 32652. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32651
- 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 RVU18.31 · 59%
- Practice expense (office) RVU8.27 · 27%
- Malpractice RVU4.55 · 15%
2K
Medicare services in 2024 · #2471 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.
32651 compared with similar codes
Office rates for Alaska, from the same CMS release.
No office rate
Use 32653 for removal of a foreign body or fibrin deposit from the pleural space. Use 32651 when the operation is partial decortication of the lung.
No office rate
32650 describes thoracoscopic pleurodesis, not removal of a restrictive pleural peel to free the lung.
No office rate
32656 is for thoracoscopic pleurectomy. Distinguish it from 32651 by the procedure actually performed and documented.
Compare 32651 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
Alaska* →
Office / nonfacility
Unavailable
Facility
$1295.27
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 32651 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
3,748
- Code
- 32651
- Physician work
- 18.31
- Practice expense
- 8.27
- Malpractice
- 4.55
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.31 | × 1.500 | 27.4650 |
| Practice expense | 8.27 | × 1.065 | 8.8075 |
| Malpractice | 4.55 | × 0.551 | 2.5071 |
| Total RVUs | 38.7796 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alaska*$1295.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.31 | 1.5 |
| Practice expense | 8.27 | 1.065 |
| Malpractice | 4.55 | 0.551 |
(18.31 × 1.5 + 8.27 × 1.065 + 4.55 × 0.551) × $33.4009 = $1295.27
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.
32651 billing questions
How do I distinguish 32651 from 32652?
Choose 32651 when the documented pulmonary decortication is partial. Use 32652 when the surgeon documents total decortication.
Is removal of loose fibrin reported with 32651?
Not when the work is limited to removing a foreign body or fibrin deposit rather than decorticating the lung. That procedure may fit 32653.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral decortication reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% multiple-procedure reduction.
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.
3,74532609,,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
3,75132654,,Thoracoscopy contrl bleeding,A,,20.01,8.93,NA,8.93,,4.83,33.77,33.77,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609