Billing code 32606: Thoracoscopy biopsyMedicare rate & RVUs in Illinois
Report this service when a surgeon uses thoracoscopy to obtain biopsy tissue from a mediastinal mass or lesion for diagnostic evaluation.
CMS doesn’t publish an office rate for 32606 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 32606 covers
A thoracic surgeon uses a scope and instruments introduced through chest-wall ports to inspect the chest and obtain tissue from a mediastinal mass or lesion. The specimen may help evaluate an abnormality seen on imaging or clarify a suspected mediastinal disease. The service is generally performed in an operating room with the patient under anesthesia; it is not the code for sampling a lung nodule, pulmonary infiltrate, pleura, or pericardial sac.
Select the code according to the sampled target and thoracoscopic approach, and document the mediastinal site, the biopsy performed, and the operative findings. Biopsies of multiple portions of a mediastinal mass during the same session are reported as the procedure, not as separate units for each specimen. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 32606 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 | $519.55 |
| East St. Louis | Unavailable | $491.02 |
| Rest Of Illinois | Unavailable | $459.53 |
| Suburban Chicago | Unavailable | $485.65 |
How the 32606 rate is calculated
Each of 32606’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 · 32606
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.18Practice expense 2.60Malpractice 2.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32606
The CMS indicators that decide how 32606 is paid alongside other services.
CMS payment indicators · 32606
Thoracoscopy biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
32606 without 51 · national facility
$428.53
Thoracoscopy biopsy
32606-51 · Second procedure: 50%
$214.27
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
32606 compared with similar codes
Compare codes
32606 vs 32601 vs 32607 vs 32608 vs 32662: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32601Diagnostic thoracoscopy
- Use 32601 for diagnostic thoracoscopy without the mediastinal mass biopsy described here. When the surgeon biopsies the mediastinal target, select the biopsy service.
- 32607Lung biopsy
- 32607 is for thoracoscopic biopsy of a pulmonary infiltrate. This code is selected when the tissue comes from a mediastinal mass or lesion.
- 32608Thoracoscopic biopsy
- 32608 describes biopsy of a lung nodule. Choose this code for a mediastinal mass biopsy, not a nodule within lung parenchyma.
- 32662Mediastinal excision
- 32662 describes thoracoscopic excision of a mediastinal lesion. This code applies when the surgeon obtains biopsy tissue rather than performing the excision service.
32606 billing questions
How is this different from a thoracoscopic lung biopsy code?
Use this code when the sampled target is a mediastinal mass or lesion. Codes 32607 and 32608 describe biopsy of a pulmonary infiltrate and lung nodule, respectively.
Can multiple mediastinal biopsy specimens be billed as multiple units?
The service covers biopsy of the mediastinal target, including multiple biopsy samples obtained during the same session. Do not count each specimen as a separate unit.
Is a separate diagnostic thoracoscopy also reported?
When the thoracoscopy includes biopsy of the mediastinal mass, report the biopsy service rather than separately reporting diagnostic thoracoscopy for the same operative inspection.
Can modifier 50 be used when both sides are sampled?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 is not appropriate.
What documentation supports this code?
The operative report should identify the mediastinal target, confirm that the surgeon obtained biopsy tissue, and describe the thoracoscopic approach.
When is an assistant-at-surgery payable?
CMS payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are 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 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
Fee sheets
Put 32606 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →