No office rate
Both codes include apical tumor and chest wall resection. Select 32504 when the chest wall is reconstructed; select 32503 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
32503 Lung tumor resection Medicare reimbursement rates in Idaho
Open resection of an apical lung tumor with involved chest wall, reported when the operation does not include chest wall reconstruction. Compare 32503 office and facility rates across CMS payment localities in Idaho.
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 32503 in Idaho?
Idaho 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
$1523.74
1 of 1 localities have a supported rate.
Payment area: Idaho
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 32503: Apical lung tumor resection without reconstruction
Open resection of an apical lung tumor with involved chest wall, reported when the operation does not include chest wall reconstruction.
Code 32503 represents an open major thoracic operation to remove an apical lung tumor, commonly a superior sulcus (Pancoast) tumor, together with involved chest wall. A thoracic surgeon performs the resection through thoracotomy in an operating room. The code distinguishes the operation in which the chest wall is not reconstructed. The specimen may include the apical lung lesion and a contiguous portion of chest wall removed as one oncologic resection.
Report 32503 when the operative report supports apical tumor resection with chest wall resection and no chest wall reconstruction; a diagnostic wedge resection or a lung resection without this apical and chest wall operation is not equivalent. The record should identify tumor location, structures removed, and whether reconstruction occurred. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32503
- 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 RVU30.95 · 61%
- Practice expense (office) RVU11.93 · 24%
- Malpractice RVU7.81 · 15%
22
Medicare services in 2024 · #5865 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.
32503 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
32505 describes an open wedge or segmental lung resection. It does not represent the apical tumor resection with chest wall resection described by 32503.
No office rate
32507 is for diagnostic lung wedge resection. 32503 represents therapeutic resection of an apical tumor with involved chest wall.
Compare 32503 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
Idaho →
Office / nonfacility
Unavailable
Facility
$1523.74
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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 32503 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
3,722
- Code
- 32503
- Physician work
- 30.95
- Practice expense
- 11.93
- Malpractice
- 7.81
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 30.95 | × 1.000 | 30.9500 |
| Practice expense | 11.93 | × 0.920 | 10.9756 |
| Malpractice | 7.81 | × 0.473 | 3.6941 |
| Total RVUs | 45.6197 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$1523.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 30.95 | 1 |
| Practice expense | 11.93 | 0.92 |
| Malpractice | 7.81 | 0.473 |
(30.95 × 1 + 11.93 × 0.92 + 7.81 × 0.473) × $33.4009 = $1523.74
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.
32503 billing questions
What distinguishes 32503 from 32504?
Both describe apical lung tumor resection with chest wall resection. Use 32503 when the chest wall is not reconstructed and 32504 when reconstruction is performed.
Can the chest wall resection be billed separately?
Chest wall resection is part of the operation represented by 32503. The operative report should establish that it was performed as part of the apical tumor resection.
What should the operative report document?
Document the apical tumor location, lung and chest wall structures removed, and whether chest wall reconstruction was performed.
How does the multiple procedure reduction work?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
What are the global and surgical team payment rules?
The 90-day global includes the day-before preoperative visit and related postoperative care. An assistant at surgery may be paid, co-surgeon payment requires supporting documentation, and 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.
3,71932488,,Completion pneumonectomy,A,,41.92,14.55,NA,14.55,,10.57,67.04,67.04,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72032491,,Lung volume reduction,R,,24.61,11.33,NA,11.33,,6.20,42.14,42.14,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72132501,,Repair bronchus add-on,A,,4.56,0.90,NA,0.90,,1.15,6.61,6.61,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72232503,,Resect apical lung tumor,A,,30.95,11.93,NA,11.93,,7.81,50.69,50.69,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72332504,,Resect apical lung tum/chest,A,,35.63,12.85,NA,12.85,,8.99,57.47,57.47,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72432505,,Wedge resect of lung initial,A,,15.36,7.62,NA,7.62,,3.81,26.79,26.79,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72532506,,Wedge resect of lung add-on,A,,2.93,0.58,NA,0.58,,0.72,4.23,4.23,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772