Billing code 32655: Bulla resectionMedicare rate & RVUs in Illinois
Reports thoracoscopic removal of pulmonary bullae, commonly during surgery for spontaneous pneumothorax or symptomatic bullous lung disease.
CMS doesn’t publish an office rate for 32655 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 32655 covers
A thoracic surgeon uses a thoracoscopic approach to remove one or more abnormal air-filled spaces in the lung, often to treat a persistent or recurrent spontaneous pneumothorax or symptomatic bullous disease. The service is generally performed in an operating room, with the resected bulla removed through the thoracic access sites. The code includes pleural procedures performed as part of the bulla resection.
The operative report should identify the bulla resected, its location, the thoracoscopic approach, and the clinical reason for surgery. This major procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 32655 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 | $1,091.68 |
| East St. Louis | Unavailable | $1,029.06 |
| Rest Of Illinois | Unavailable | $967.76 |
| Suburban Chicago | Unavailable | $1,028.34 |
How the 32655 rate is calculated
Each of 32655’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 · 32655
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.77Practice expense 7.70Malpractice 3.95
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32655
32655 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32655
Bulla resection
| 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 · 32655
Bulla resection
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
32655 without 50 · national facility
$915.85
Bulla resection
32655-50 · Bilateral: 150%
$1,373.78
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).
32655 compared with similar codes
Compare codes
32655 vs 32666 vs 32650 vs 32656 vs 32651: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32666Lung wedge resection
- 32655 is for resection of pulmonary bullae. Use 32666 when the surgeon performs a thoracoscopic wedge resection for another lung target.
- 32650Pleurodesis
- 32650 describes thoracoscopic pleurodesis. Pleural work performed as part of 32655 is included in the bulla-resection service.
- 32656Thoracoscopic pleurectomy
- 32656 is thoracoscopic pleurectomy. It is distinguished by removal of pleural tissue as the operative service rather than resection of a pulmonary bulla.
- 32651Thoracoscopic decortication
- 32651 describes thoracoscopic decortication, which removes a restrictive layer from the lung or pleura; 32655 removes pulmonary bullae.
32655 billing questions
How is 32655 different from thoracoscopic wedge resection?
Use 32655 when the target is a pulmonary bulla. Code 32666 describes thoracoscopic wedge resection for a different lung target, such as a lesion requiring wedge removal.
Can pleurodesis be reported separately with 32655?
Pleural procedures performed as part of the bulla resection are included in 32655. Do not separately report 32650 for pleurodesis that is part of that service.
What documentation supports 32655?
Document the thoracoscopic approach, the bulla removed and its lung location, and the indication, such as persistent pneumothorax or symptomatic bullous disease.
How does Medicare handle bilateral bulla resection?
The CMS rule pays bilateral reporting with modifier 50 at 150%. The operative record should support treatment on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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 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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