No office rate
Choose 32905 for reconstruction with prosthetic material; choose 32906 when the repair uses a muscle flap.
On this page
CMS RVU26D · Effective 2026-10-01
32905 Chest wall repair Medicare reimbursement rates in Hawaii
Reports operative reconstruction of a chest-wall defect with prosthetic material, such as mesh, after trauma or a prior operation. Compare 32905 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 32905 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
$1230.69
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 32905: Chest wall repair with prosthetic material
Reports operative reconstruction of a chest-wall defect with prosthetic material, such as mesh, after trauma or a prior operation.
Code 32905 describes surgical reconstruction of a chest-wall defect using prosthetic material, commonly mesh. A thoracic surgeon typically performs the repair in an operating room when a defect from trauma or a prior operation requires structural coverage. The operative note should identify the defect and its cause, describe the reconstruction, and document the prosthetic material used. A repair using a muscle flap is distinguished by code 32906; rib removal alone is not this service.
This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple 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. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32905
- 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 RVU22.71 · 60%
- Practice expense (office) RVU9.52 · 25%
- Malpractice RVU5.72 · 15%
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.
32905 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
32900 describes rib removal. It does not identify reconstruction of a chest-wall defect with prosthetic material.
No office rate
21811 addresses open internal fixation of rib fractures; 32905 addresses prosthetic reconstruction of a chest-wall defect.
Compare 32905 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
$1230.69
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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 32905 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,800
- Code
- 32905
- Physician work
- 22.71
- Practice expense
- 9.52
- Malpractice
- 5.72
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.71 | × 1.000 | 22.7100 |
| Practice expense | 9.52 | × 1.137 | 10.8242 |
| Malpractice | 5.72 | × 0.579 | 3.3119 |
| Total RVUs | 36.8461 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1230.69
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.71 | 1 |
| Practice expense | 9.52 | 1.137 |
| Malpractice | 5.72 | 0.579 |
(22.71 × 1 + 9.52 × 1.137 + 5.72 × 0.579) × $33.4009 = $1230.69
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.
32905 billing questions
How do I distinguish 32905 from 32906?
Use 32905 when the chest-wall reconstruction uses prosthetic material. Code 32906 identifies repair using a muscle flap.
Does rib removal alone support 32905?
No. Rib removal without prosthetic chest-wall reconstruction is a different service; 32905 describes reconstruction of a defect using prosthetic material.
What documentation supports 32905?
Document the chest-wall defect and its cause, the operative reconstruction, and the prosthetic material used.
Should modifier 50 be appended for repair on both sides?
No. Modifier 50 is inappropriate for this service.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90 days after surgery are included in the global period.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
3,7973285F,,Iop down <15% of pre-svc lvl,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
3,7983288F,,Fall risk assessment 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
3,79932900,,Removal of rib(s),A,,23.21,9.62,NA,9.62,,5.85,38.68,38.68,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,80032905,,Revise & repair chest wall,A,,22.71,9.52,NA,9.52,,5.72,37.95,37.95,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,80132906,,Revise & repair chest wall,A,,28.57,10.67,NA,10.67,,7.21,46.45,46.45,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8023290F,,Pt=d(rh)- and unsensitized,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
3,8033291F,,Pt=d(rh)+ or sensitized,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
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