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CMS RVU26D · Effective 2026-10-01

32661 Pericardial excision Medicare reimbursement rates in Iowa

Reports thoracoscopic surgical removal of a pericardial cyst or mass, rather than drainage alone or a biopsy of another thoracic structure. Compare 32661 office and facility rates across CMS payment localities in Iowa.

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 32661 in Iowa?

Iowa 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

$686.48

1 of 1 localities have a supported rate.

Payment area: Iowa

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 32661 in your payment locality →

Thoracic surgery

About 32661: Thoracoscopic pericardial lesion excision

Reports thoracoscopic surgical removal of a pericardial cyst or mass, rather than drainage alone or a biopsy of another thoracic structure.

Code 32661 describes an operation in which the surgeon uses a thoracoscope to inspect the pericardium and excise a cyst or mass. It is typically performed by a thoracic or cardiothoracic surgeon in an operating room, often using a video-assisted thoracoscopic approach. The operative report should establish that the lesion arises from the pericardium and was excised; a procedure limited to draining the pericardial sac or sampling pleura is a different service.

Report the code for the thoracoscopic excision, and document the lesion’s location, the approach, and the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.

CMS billing rules for 32661

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 RVU13.00 · 56%
  • Practice expense (office) RVU6.84 · 30%
  • Malpractice RVU3.26 · 14%

79

Medicare services in 2024 · #5060 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.

32661 compared with similar codes

Office rates for Iowa, from the same CMS release.

32659

Pericardial drainage

Thoracoscopic approach

No office rate

32661 is for excising a pericardial cyst or mass; 32659 is for thoracoscopic drainage of the pericardial sac.

32662

Mediastinal excision

Thoracoscopic cyst, tumor, or mass

No office rate

Choose based on the lesion’s origin: 32661 covers a pericardial lesion, while 32662 covers a mediastinal cyst, tumor, or mass.

32609

Pleural biopsy

Thoracoscopic approach

No office rate

32661 removes a pericardial cyst or mass. Code 32609 is for thoracoscopic biopsy of pleura, not excision of a pericardial lesion.

Compare 32661 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

  • Iowa →

    Office / nonfacility

    Unavailable

    Facility

    $686.48

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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 32661 in Iowa.

PPRRVU2026_Oct_nonQPP.csv

3,757

Code
32661
Physician work
13.00
Practice expense
6.84
Malpractice
3.26

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Facility calculation for 32661 in Iowa
ComponentRVULocality factorAdjusted
Physician work13.00× 1.00013.0000
Practice expense6.84× 0.9156.2586
Malpractice3.26× 0.3971.2942
Total RVUs20.5528
Conversion factor× 33.4009

Facility rate, Iowa$686.48

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work131
Practice expense6.840.915
Malpractice3.260.397

(13 × 1 + 6.84 × 0.915 + 3.26 × 0.397) × $33.4009 = $686.48

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.

32661 billing questions

How is this different from 32659?

32661 is for thoracoscopic excision of a pericardial cyst or mass. Code 32659 describes thoracoscopic drainage of the pericardial sac.

When would 32662 be considered instead?

Use 32662 when the excised cyst, tumor, or mass is mediastinal rather than pericardial. The operative report should identify the structure of origin.

Does this code include drainage of the pericardial sac?

The service represented by 32661 is excision of a pericardial cyst or mass. Drainage alone is represented by 32659.

Can modifier 50 be appended for bilateral work?

No. Modifier 50 is inappropriate for this code.

What global period and multiple-procedure rules apply?

The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

What should the operative report document?

Document that the lesion is pericardial, the thoracoscopic approach, and the excision performed. If co-surgeon payment is claimed, supporting documentation is required.

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 32661PPRRVU2026_Oct_nonQPP.csv, line 3,757 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet