Billing code 32225: Lung decorticationMedicare rate & RVUs in Illinois
Reports open surgical removal of part of a fibrous covering that restricts lung expansion, commonly for a trapped lung after pleural disease.
CMS doesn’t publish an office rate for 32225 in Illinois.
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 32225 covers
The surgeon opens the chest and removes part of the fibrous peel constricting the lung, allowing the affected portion to expand more freely. This operation may be used for a trapped lung associated with chronic pleural inflammation, empyema, or retained blood. Thoracic surgeons typically perform it in a hospital operating room. The code represents partial pulmonary decortication through an open approach; video-assisted thoracoscopic decortication is represented by a different code family.
Choose partial rather than complete decortication based on the extent of peel removed, not simply the underlying diagnosis. The operative report should describe the affected lung, the fibrous restriction, the portion released, and the open approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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 32225 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,138.85 |
| East St. Louis | Unavailable | $1,073.35 |
| Rest Of Illinois | Unavailable | $1,010.11 |
| Suburban Chicago | Unavailable | $1,073.83 |
How the 32225 rate is calculated
Each of 32225’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 · 32225
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.33Practice expense 8.27Malpractice 4.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32225
32225 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32225
Lung 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 · 32225
Lung 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
32225 without 50 · national facility
$957.60
Lung decortication
32225-50 · Bilateral: 150%
$1,436.40
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).
32225 compared with similar codes
Compare codes
32225 vs 32220 vs 32215 vs 32651 vs 32652: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32220Lung decortication
- Both are open pulmonary decortication; 32225 is for partial release, while 32220 represents complete decortication.
- 32215Pleurectomy
- 32215 concerns removal of parietal pleura. Code 32225 releases the lung by removing a constricting fibrous peel from its surface.
- 32651Thoracoscopic decortication
- Both represent partial pulmonary decortication, but 32651 is for a thoracoscopic operation; 32225 is the open approach.
- 32652Thoracoscopic decortication
- 32652 describes complete thoracoscopic pulmonary decortication. Code 32225 describes partial decortication through an open approach.
32225 billing questions
How does 32225 differ from 32220?
Both describe open pulmonary decortication. Use 32225 when the surgeon releases part of the lung; 32220 represents complete decortication.
When is a thoracoscopic decortication code used instead?
Use the thoracoscopic code that matches the extent when the operation is performed by video-assisted thoracoscopy rather than an open thoracotomy. Codes 32651 and 32652 distinguish partial from complete decortication.
Can partial and complete decortication both be reported for the same lung in one operation?
Do not report both to describe the overall extent of decortication at the same site. Select the code that reflects the operation performed.
What documentation supports 32225?
Document the fibrous restriction, the lung area released, the extent of peel removed, and that the surgeon used an open approach.
How are bilateral procedures and assistant services handled?
CMS pays bilateral reporting with modifier 50 at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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