Billing code 32652: Thoracoscopic decorticationMedicare rate & RVUs in Guam
Reports thoracoscopic removal of an organized pleural peel across the lung to release restriction, typically for empyema or fibrothorax.
CMS doesn’t publish an office rate for 32652 in Guam.
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 32652 covers
During video-assisted thoracic surgery, the surgeon removes an organized fibrous peel from the lung surface to free a restricted lung and permit expansion. This total decortication is commonly performed for organized empyema, fibrothorax, or trapped lung. A parietal pleurectomy, when performed as part of the operation, is included. Thoracic surgeons typically perform the procedure in an operating room, generally in a hospital facility.
Choose this code when the operative work constitutes total pulmonary decortication, rather than the partial decortication represented by 32651. The operative report should describe the pleural disease, the extent of peel removal, and the lung’s release or expansion. 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 are subject to the standard reduction. For bilateral surgery, modifier 50 is paid at 150%. 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.
32652 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,522.44 |
How the 32652 rate is calculated
Each of 32652’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 · 32652
RVUs × geographic indexes × conversion factor
Work28.40
28.40 RVUs× 1.000 GPCI
Practice expense11.49
11.49 RVUs× 1.000 GPCI
Malpractice7.11
7.11 RVUs× 1.000 GPCI
Adjusted RVUs
47.0000
Conversion factor
$33.4009
Medicare rate
$1,569.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32652
32652 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32652
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 · 32652
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
32652 without 50 · national facility
$1,569.84
Thoracoscopic decortication
32652-50 · Bilateral: 150%
$2,354.76
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).
32652 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 32651Thoracoscopic decortication
- 32651 describes partial pulmonary decortication; 32652 is for total decortication. Base selection on the extent documented in the operative report.
- 32656Thoracoscopic pleurectomy
- 32656 is for thoracoscopic pleurectomy. Use 32652 when the procedure is total pulmonary decortication, including parietal pleurectomy when performed.
- 32653Thoracoscopy removal
- 32653 addresses removal of foreign material or fibrin from the pleural cavity, rather than total removal of an organized peel restricting the lung.
32652 billing questions
How do I distinguish 32652 from 32651?
Use 32652 for total pulmonary decortication and 32651 for partial decortication. The operative report should establish the extent of the work.
Is parietal pleurectomy separately reported?
A parietal pleurectomy performed as part of the total decortication is included in 32652.
Does this code have a global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS treat bilateral surgery?
CMS pays bilateral surgery reported with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 other procedures are subject to the standard 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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