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CMS RVU26D · Effective 2026-10-01

32650 Pleurodesis Medicare reimbursement rates in Indiana

Thoracoscopic pleurodesis creates adhesion between pleural surfaces, commonly to reduce recurrence of pneumothorax or manage recurrent pleural effusion. Compare 32650 office and facility rates across CMS payment localities in Indiana.

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 32650 in Indiana?

Indiana 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

$590.88

1 of 1 localities have a supported rate.

Payment area: Indiana

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.

Find 32650 in your payment locality →

Thoracic surgery

About 32650: Thoracoscopic pleurodesis

Thoracoscopic pleurodesis creates adhesion between pleural surfaces, commonly to reduce recurrence of pneumothorax or manage recurrent pleural effusion.

A thoracic surgeon performs this operation through a thoracoscope to make the visceral and parietal pleura adhere, using a mechanical or chemical technique. Common situations include recurrent pneumothorax and recurrent pleural effusion, including effusion associated with malignancy. The service is typically performed in an operating room or hospital setting under general anesthesia.

Report the code for the thoracoscopic pleurodesis itself, with the operative report identifying the indication, approach, and method used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 50% reduction. For a bilateral procedure reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 32650

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 procedure with modifier 50 is paid at 150%.
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 RVU10.56 · 54%
  • Practice expense (office) RVU6.35 · 33%
  • Malpractice RVU2.56 · 13%

3.8K

Medicare services in 2024 · #2030 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.

32650 compared with similar codes

Office rates for Indiana, from the same CMS release.

32560

Chemical pleurodesis

Via chest tube or catheter

$256.33

Code 32560 describes chemical pleurodesis through a chest tube. Use 32650 when the pleurodesis is performed with a thoracoscopic approach.

32609

Pleural biopsy

Thoracoscopic approach

No office rate

Code 32609 represents thoracoscopic pleural biopsy. It describes diagnostic tissue sampling, not pleural adhesion treatment.

32656

Thoracoscopic pleurectomy

Parietal pleura removal

No office rate

Code 32656 describes thoracoscopic pleurectomy, which removes pleural tissue. Code 32650 is for creating pleural adhesion without coding the service as pleurectomy.

Compare 32650 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

Office and facility base rates · shared scale starting at $0

  • Indiana →

    Office / nonfacility

    Unavailable

    Facility

    $590.88

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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 32650 in Indiana.

PPRRVU2026_Oct_nonQPP.csv

3,747

Code
32650
Physician work
10.56
Practice expense
6.35
Malpractice
2.56

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Facility calculation for 32650 in Indiana
ComponentRVULocality factorAdjusted
Physician work10.56× 1.00010.5600
Practice expense6.35× 0.9275.8864
Malpractice2.56× 0.4861.2442
Total RVUs17.6906
Conversion factor× 33.4009

Facility rate, Indiana$590.88

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work10.561
Practice expense6.350.927
Malpractice2.560.486

(10.56 × 1 + 6.35 × 0.927 + 2.56 × 0.486) × $33.4009 = $590.88

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.

32650 billing questions

When should I report this instead of code 32560?

Report this code when pleurodesis is performed thoracoscopically. Code 32560 describes chemical pleurodesis delivered through a chest tube without a thoracoscopic approach.

How does this differ from thoracoscopic pleurectomy?

Pleurodesis brings the pleural surfaces together to form an adhesion. Pleurectomy removes pleural tissue and is a different operative approach.

Can a pleural biopsy be reported during the same operation?

A pleural biopsy may be performed for diagnostic evaluation during the encounter. Documentation should identify the biopsy site and its separate purpose; apply applicable coding edits when reporting both services.

What does the 90-day global period include?

It includes the day-before preoperative visit and related postoperative care for 90 days after surgery.

How is bilateral pleurodesis handled under the CMS payment facts?

For a bilateral procedure reported with modifier 50, CMS pays at 150%.

May an assistant surgeon be paid for this operation?

CMS permits assistant-at-surgery payment. Co-surgeon payment requires supporting documentation, while 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.

RVUs for 32650PPRRVU2026_Oct_nonQPP.csv, line 3,747 (RVU26D)
Geographic factors for IndianaGPCI2026.csv, line 52 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet