No office rate
Choose 32609 when pleural tissue is sampled. Choose 32601 for diagnostic thoracoscopy when no pleural biopsy is performed.
On this page
CMS RVU26D · Effective 2026-10-01
32609 Pleural biopsy Medicare reimbursement rates in Arkansas
Report this service when a surgeon uses thoracoscopy to obtain pleural tissue, such as for evaluation of unexplained effusion or abnormal pleura. Compare 32609 office and facility rates across CMS payment localities in Arkansas.
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 32609 in Arkansas?
Arkansas 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
$215.28
1 of 1 localities have a supported rate.
Payment area: Arkansas
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 32609: Thoracoscopic pleural biopsy
Report this service when a surgeon uses thoracoscopy to obtain pleural tissue, such as for evaluation of unexplained effusion or abnormal pleura.
A thoracic surgeon uses a scope passed through the chest wall to inspect the pleural space and collect tissue from the pleura. This is commonly performed in a hospital operating room when imaging or prior evaluation shows pleural thickening, nodules, or an unexplained effusion and tissue is needed to investigate possible malignancy, infection, or another pleural disorder. The specimen is sent for pathologic examination.
Report the code when pleural tissue is sampled; the scope inspection needed to locate and obtain that sample is part of the service, rather than a separate diagnostic thoracoscopy. The operative report should identify the pleural target and document that tissue was collected. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 32609
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.47 · 63%
- Practice expense (office) RVU1.73 · 24%
- Malpractice RVU0.95 · 13%
1.4K
Medicare services in 2024 · #2744 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.
32609 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
32609 covers sampling pleura; 32606 is for thoracoscopic biopsy of the mediastinal space.
No office rate
32609 is selected for a pleural specimen. 32607 applies when the sampled target is a pulmonary infiltrate.
No office rate
Use 32609 for pleural tissue and 32608 when thoracoscopic biopsy targets a pulmonary nodule.
Compare 32609 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
Arkansas →
Office / nonfacility
Unavailable
Facility
$215.28
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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 32609 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
3,745
- Code
- 32609
- Physician work
- 4.47
- Practice expense
- 1.73
- Malpractice
- 0.95
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.47 | × 1.000 | 4.4700 |
| Practice expense | 1.73 | × 0.859 | 1.4861 |
| Malpractice | 0.95 | × 0.515 | 0.4892 |
| Total RVUs | 6.4453 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$215.28
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.47 | 1 |
| Practice expense | 1.73 | 0.859 |
| Malpractice | 0.95 | 0.515 |
(4.47 × 1 + 1.73 × 0.859 + 0.95 × 0.515) × $33.4009 = $215.28
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.
32609 billing questions
When should this be chosen over diagnostic thoracoscopy?
Use this code when pleural tissue is obtained. A diagnostic thoracoscopy without pleural biopsy is represented by 32601.
Can diagnostic thoracoscopy also be reported?
Do not separately report 32601 for the visualization used to locate and obtain the pleural biopsy; that inspection is part of this service.
Can pleurodesis be performed and reported in the same session?
Pleurodesis may be performed during the same thoracoscopy as pleural biopsy. When both procedures are reported, CMS applies the multiple-procedure reduction to the lower-valued procedure or procedures.
Should modifier 50 be appended for bilateral pleural sampling?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What documentation supports reporting the biopsy?
The operative report should establish that the sampled tissue was pleura, describe the target or abnormality, and document that a specimen was obtained.
When is assistant-at-surgery payment available?
CMS allows assistant-at-surgery payment only when the record documents medical necessity. Co-surgeons and team surgery are 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.
3,74232606,,Thoracoscopy w/bx med space,A,,8.18,2.60,NA,2.60,,2.05,12.83,12.83,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74332607,,Thoracoscopy w/bx infiltrate,A,,5.36,1.97,NA,1.97,,1.33,8.66,8.66,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74432608,,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
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
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541