No office rate
Use 32220 for complete pulmonary release and 32225 when decortication is partial. The operative description of extent determines the choice.
On this page
CMS RVU26D · Effective 2026-10-01
32220 Lung decortication Medicare reimbursement rates in California
Removal of a restrictive fibrous layer from the lung to permit re-expansion, typically for trapped lung associated with empyema or other pleural disease. Compare 32220 office and facility rates across CMS payment localities in California.
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 32220 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1496.57–$1734.55
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $237.98 per service.
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.
Where 32220 pays more and less in California
Thoracic surgery
About 32220: Complete pulmonary decortication
Removal of a restrictive fibrous layer from the lung to permit re-expansion, typically for trapped lung associated with empyema or other pleural disease.
Pulmonary decortication removes a dense fibrous peel constricting the lung so the lung can expand. Thoracic surgeons typically perform the operation in a hospital operating room, often through an open chest approach, for a trapped lung associated with empyema or other pleural disease. The work is directed at freeing the lung, rather than draining a lung abscess or removing only parietal pleura.
Report 32220 when the operative record supports complete pulmonary decortication; use the partial-decortication code when only part of the lung is released. Documentation should identify the restrictive peel, the extent of its removal, and the resulting release of the lung. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 32220
- 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 RVU25.98 · 56%
- Practice expense (office) RVU13.61 · 30%
- Malpractice RVU6.47 · 14%
1.3K
Medicare services in 2024 · #2763 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.
32220 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
32652 describes total decortication performed thoracoscopically. Compare the documented surgical approach before selecting it instead of 32220.
No office rate
32215 concerns removal of parietal pleura; 32220 frees the lung by removing its constricting fibrous peel. The operative target distinguishes them.
No office rate
32200 addresses open drainage of a lung abscess or cyst. It does not describe releasing a lung constrained by a fibrous peel.
Compare 32220 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1514.08 |
| Chico | Office Unavailable | Facility $1496.57 |
| El Centro | Office Unavailable | Facility $1497.65 |
| Fresno | Office Unavailable | Facility $1496.57 |
| Hanford-Corcoran | Office Unavailable | Facility $1496.57 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1584.60 |
| Madera | Office Unavailable | Facility $1496.57 |
| Merced | Office Unavailable | Facility $1496.57 |
| Modesto | Office Unavailable | Facility $1496.57 |
| Napa | Office Unavailable | Facility $1631.35 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1564.01 |
| Redding | Office Unavailable | Facility $1496.57 |
| Rest Of California | Office Unavailable | Facility $1496.57 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1565.94 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1543.51 |
| Salinas | Office Unavailable | Facility $1537.35 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1554.60 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1690.35 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1683.00 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1734.55 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1704.52 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1516.11 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1554.13 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1537.93 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1567.85 |
| Stockton | Office Unavailable | Facility $1496.57 |
| Vallejo | Office Unavailable | Facility $1620.76 |
| Visalia | Office Unavailable | Facility $1496.57 |
| Yuba City | Office Unavailable | Facility $1496.57 |
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32220 billing questions
How is 32220 different from 32225?
32220 is for complete pulmonary decortication. Use 32225 when the operative work releases only part of the lung.
What documentation supports complete decortication?
The operative report should describe the restrictive fibrous peel, its removal from the lung, and the extent of the release. The documented work should support complete rather than partial decortication.
Can 32220 be reported with thoracoscopic decortication codes?
For thoracoscopic total decortication, compare 32220 with 32652; for thoracoscopic partial decortication, compare it with 32651. Select the code matching the documented approach and extent rather than reporting both for the same work.
Does the 90-day global period include postoperative visits?
Yes. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle bilateral reporting and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%.
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.
3,70232200,,Drain open lung lesion,A,,18.21,10.41,NA,10.41,,4.58,33.20,33.20,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,7033220F,,Hep c quant rna tstng 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
3,70432215,,Treat chest lining,A,,12.72,7.55,NA,7.55,,3.19,23.46,23.46,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,70532220,,Release of lung,A,,25.98,13.61,NA,13.61,,6.47,46.06,46.06,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,70632225,,Partial release of lung,A,,16.33,8.27,NA,8.27,,4.07,28.67,28.67,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,7073230F,,Note hring tst w/in 6 mon,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
3,70832310,,Removal of chest lining,A,,14.90,7.98,NA,7.98,,3.75,26.63,26.63,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00