Billing code 32659: Pericardial drainageMedicare rate & RVUs in Georgia
Report this service when a surgeon uses thoracoscopy to drain fluid from the pericardial sac, commonly for a pericardial effusion.
CMS doesn’t publish an office rate for 32659 in Georgia.
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 32659 covers
A thoracic surgeon uses a thoracoscope to reach and drain fluid from the sac surrounding the heart. In an operating room, this may involve creating a pericardial window so fluid can drain into the chest. The service is used for pericardial effusions requiring surgical drainage; it is distinct from needle drainage through the skin.
Report 32659 when the operative work is thoracoscopic drainage of the pericardial sac. The operative note should establish the thoracoscopic approach, the pericardial fluid or collection treated, and the drainage performed; distinguish this from removal of a foreign body or excision of pericardium. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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.
Where 32659 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $740.84 |
| Rest Of Georgia | Unavailable | $710.22 |
How the 32659 rate is calculated
Each of 32659’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 · 32659
RVUs × geographic indexes × conversion factor
Work11.64
11.64 RVUs× 1.000 GPCI
Practice expense6.90
6.90 RVUs× 1.000 GPCI
Malpractice2.91
2.91 RVUs× 1.000 GPCI
Adjusted RVUs
21.4500
Conversion factor
$33.4009
Medicare rate
$716.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32659
32659 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32659
Pericardial drainage
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 32659
Pericardial drainage
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 51 · payment effect
With and without the modifier
32659 without 51 · national facility
$716.45
Pericardial drainage
32659-51 · Second procedure: 50%
$358.23
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
32659 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 32658Thoracoscopy
- Use 32659 for thoracoscopic drainage of the pericardial sac. Use 32658 when the thoracoscopic work removes a foreign body from the sac.
- 33016Pericardiocentesis
- 33016 is percutaneous pericardiocentesis with imaging guidance. Choose 32659 when the surgeon performs drainage through a thoracoscopic approach.
- 33025Pericardial window
- 33025 describes creation of a pericardial window or partial resection for drainage. 32659 identifies thoracoscopic drainage.
32659 billing questions
How is 32659 different from pericardiocentesis?
32659 is for surgical drainage performed through a thoracoscopic approach. Pericardiocentesis uses percutaneous needle or catheter access rather than thoracoscopic surgery.
How is 32659 different from 32658?
32659 covers drainage of the pericardial sac. 32658 is for thoracoscopic removal of a foreign body from that sac.
Does 32659 include creation of a pericardial window?
A thoracoscopic window may be part of the drainage procedure. The operative note should describe the approach and the work performed.
What documentation supports reporting 32659?
Document the thoracoscopic approach, the pericardial collection treated, and the drainage performed. The note should make clear that the service was drainage rather than foreign-body removal or pericardiectomy.
What global period applies to 32659?
CMS assigns a 90-day global period. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported for 32659?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this pericardial-sac service.
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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