No office rate
32100 describes exploratory thoracotomy without the penetrating-wound repair included in 32110. The repair of a penetrating injury is the key distinction.
On this page
CMS RVU26D · Effective 2026-10-01
32110 Chest exploration Medicare reimbursement rates in Hawaii
Open-chest exploration and repair for a penetrating injury, such as a stab or gunshot wound, with or without bleeding control. Compare 32110 office and facility rates across CMS payment localities in Hawaii.
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 32110 in Hawaii?
Hawaii 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
$1360.56
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 32110: Thoracotomy for penetrating chest wound repair
Open-chest exploration and repair for a penetrating injury, such as a stab or gunshot wound, with or without bleeding control.
A surgeon opens the chest to assess and repair damage from a penetrating injury, such as a stab or gunshot wound. The operation may include repairing injured intrathoracic tissue and controlling hemorrhage. Thoracic and general surgeons typically perform this urgent procedure in a hospital operating room, often after trauma evaluation identifies a chest injury requiring operative treatment.
Report this code when the operative service includes exploration and repair of a penetrating chest wound; the operative report should establish the injury, the findings, and the repair performed. Exploration and hemorrhage control are part of the service described, not separate reasons to report this code more than once. CMS assigns a 90-day global period, including the day-before preoperative visit and 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 not appropriate for this service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32110
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU24.65 · 59%
- Practice expense (office) RVU11.04 · 26%
- Malpractice RVU6.10 · 15%
231
Medicare services in 2024 · #4197 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.
32110 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
32120 is used when a prior thoracotomy is reopened for re-exploration. 32110 addresses exploration and repair of a penetrating chest injury.
No office rate
32124 addresses open intrapleural adhesiolysis. Choose 32110 when the operative service is repair of a penetrating wound.
Compare 32110 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1360.56
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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 32110 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,691
- Code
- 32110
- Physician work
- 24.65
- Practice expense
- 11.04
- Malpractice
- 6.10
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.65 | × 1.000 | 24.6500 |
| Practice expense | 11.04 | × 1.137 | 12.5525 |
| Malpractice | 6.10 | × 0.579 | 3.5319 |
| Total RVUs | 40.7344 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1360.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.65 | 1 |
| Practice expense | 11.04 | 1.137 |
| Malpractice | 6.1 | 0.579 |
(24.65 × 1 + 11.04 × 1.137 + 6.1 × 0.579) × $33.4009 = $1360.56
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.
32110 billing questions
When should 32110 be chosen over 32100?
Use 32110 when the thoracotomy includes exploration and repair of a penetrating chest wound. Use 32100 for exploratory thoracotomy when the service does not include that penetrating-wound repair.
Can exploration or bleeding control be reported separately?
Exploration and hemorrhage control are included in the penetrating-wound service represented by 32110. The operative report should document the wound and repair rather than treating those elements as separate services.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. The period is tied to this major thoracotomy.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended for a wound on either side of the chest?
No. Modifier 50 is not appropriate for this code because the descriptor and anatomy are not suited to bilateral adjustment.
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.
3,68832098,,Open biopsy of lung pleura,A,,12.59,5.95,NA,5.95,,3.06,21.60,21.60,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,68932100,,Exploration of chest,A,,13.41,6.55,NA,6.55,,3.31,23.27,23.27,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,6903210F,,Grp a strep test performed,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
3,69132110,,Explore/repair chest,A,,24.65,11.04,NA,11.04,,6.10,41.79,41.79,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69232120,,Re-exploration of chest,A,,14.03,7.90,NA,7.90,,3.49,25.42,25.42,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69332124,,Explore chest free adhesions,A,,15.06,8.12,NA,8.12,,3.74,26.92,26.92,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69432140,,Removal of lung lesion(s),A,,16.24,8.28,NA,8.28,,4.08,28.60,28.60,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014