No office rate
32651 describes partial decortication. Choose 32653 when the operative service is removal of a foreign body or fibrin deposit, not decortication.
On this page
CMS RVU26D · Effective 2026-10-01
32653 Thoracoscopy removal Medicare reimbursement rates in Kentucky
Reports thoracoscopic removal of a foreign object or fibrin deposit from the pleural space during an operative chest procedure. Compare 32653 office and facility rates across CMS payment localities in Kentucky.
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 32653 in Kentucky?
Kentucky 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
$964.03
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Thoracic surgery
About 32653: Thoracoscopic removal of foreign body or fibrin
Reports thoracoscopic removal of a foreign object or fibrin deposit from the pleural space during an operative chest procedure.
A thoracic surgeon uses a thoracoscope to remove a foreign object or fibrinous material from the pleural space. The work is performed in an operating room, commonly during surgery for a retained intrathoracic object or fibrin deposit requiring operative removal. The operative report should identify the material and its location and describe its removal through the thoracoscopic approach.
Report this code when removal of the foreign body or fibrin deposit is the operative service, rather than pleural decortication or removal of an object from the pericardial sac. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 32653
- 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 RVU17.72 · 59%
- Practice expense (office) RVU8.18 · 27%
- Malpractice RVU4.23 · 14%
1.8K
Medicare services in 2024 · #2542 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.
32653 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
32652 describes total decortication. The operative goal and extent of decortication distinguish it from removal reported with 32653.
No office rate
32658 is for removing a foreign body from the pericardial sac; 32653 is used for the corresponding removal service in the pleural space.
Compare 32653 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$964.03
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 32653 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
3,750
- Code
- 32653
- Physician work
- 17.72
- Practice expense
- 8.18
- Malpractice
- 4.23
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.72 | × 1.000 | 17.7200 |
| Practice expense | 8.18 | × 0.889 | 7.2720 |
| Malpractice | 4.23 | × 0.915 | 3.8705 |
| Total RVUs | 28.8625 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$964.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.72 | 1 |
| Practice expense | 8.18 | 0.889 |
| Malpractice | 4.23 | 0.915 |
(17.72 × 1 + 8.18 × 0.889 + 4.23 × 0.915) × $33.4009 = $964.03
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.
32653 billing questions
How is this different from thoracoscopic decortication?
Use 32653 for removal of a foreign body or fibrin deposit. Codes 32651 and 32652 describe partial and total lung decortication, respectively; select based on the operation documented.
When is 32658 the better code?
32658 is for thoracoscopic removal of a foreign body from the pericardial sac. Use 32653 for the removal service involving the pleural space.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor or anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard 50% multiple-procedure reduction to the other procedures.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons require 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.
3,74732650,,Thoracoscopy w/pleurodesis,A,,10.56,6.35,NA,6.35,,2.56,19.47,19.47,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74832651,,Thoracoscopy remove cortex,A,,18.31,8.27,NA,8.27,,4.55,31.13,31.13,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74932652,,Thoracoscopy rem totl cortex,A,,28.40,11.49,NA,11.49,,7.11,47.00,47.00,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75032653,,Thoracoscopy remov fb/fibrin,A,,17.72,8.18,NA,8.18,,4.23,30.13,30.13,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75132654,,Thoracoscopy contrl bleeding,A,,20.01,8.93,NA,8.93,,4.83,33.77,33.77,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75232655,,Thoracoscopy resect bullae,A,,15.77,7.70,NA,7.70,,3.95,27.42,27.42,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75332656,,Thoracoscopy w/pleurectomy,A,,12.93,7.16,NA,7.16,,3.24,23.33,23.33,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631