CPT 32651: Thoracoscopic decorticationMedicare rate & RVUs in Delaware
Thoracoscopic partial lung decortication removes a restrictive pleural peel to free the lung, commonly during operative treatment of organized empyema or fibrothorax.
CMS doesn’t publish an office rate for 32651 in Delaware.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 32651 covers
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.
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 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,024.16 |
How the 32651 rate is calculated
Each of 32651’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 32651
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 18.31Practice expense 8.27Malpractice 4.55
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32651
32651 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32651
Thoracoscopic decortication
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 32651
Thoracoscopic decortication
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
32651 without 50 · national facility
$1,039.77
Thoracoscopic decortication
32651-50 · Bilateral: 150%
$1,559.66
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
32651 compared with similar codes
Compare codes
32651 vs 32652 vs 32653 vs 32650 vs 32656: national Medicare rates
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How to choose
- 32652Thoracoscopic decortication
- 32651 represents partial pulmonary decortication; 32652 is the corresponding code when the surgeon performs total decortication.
- 32653Thoracoscopy removal
- 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.
- 32650Pleurodesis
- 32650 describes thoracoscopic pleurodesis, not removal of a restrictive pleural peel to free the lung.
- 32656Thoracoscopic pleurectomy
- 32656 is for thoracoscopic pleurectomy. Distinguish it from 32651 by the procedure actually performed and documented.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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