No office rate
Choose 32664 for excision of thoracic sympathetic nerve tissue; choose 32662 when the thoracoscopic target is a mediastinal lesion.
On this page
CMS RVU26D · Effective 2026-10-01
32664 Thoracoscopic sympathectomy Medicare reimbursement rates in Maine
Reports video-assisted thoracoscopic excision of thoracic sympathetic nerve tissue, commonly performed to treat severe primary palmar hyperhidrosis. Compare 32664 office and facility rates across CMS payment localities in Maine.
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 32664 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$753.37–$771.07
2 of 2 localities have a supported rate.
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 32664: Thoracoscopic thoracic sympathectomy
Reports video-assisted thoracoscopic excision of thoracic sympathetic nerve tissue, commonly performed to treat severe primary palmar hyperhidrosis.
A thoracic surgeon uses a thoracoscopic approach to excise part of the thoracic sympathetic chain or its nerve tissue. A common indication is severe primary palmar hyperhidrosis when surgical treatment is chosen. The operation is generally performed in a hospital operating room under general anesthesia; the operative report should identify the treated side and the extent of nerve excision.
Report this code for the thoracoscopic sympathetic nerve excision, rather than for removal of a lung lobe, mediastinal mass, or thymus. Documentation should support the indication, approach, laterality, and actual excision performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures 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.
CMS billing rules for 32664
- 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 RVU13.92 · 57%
- Practice expense (office) RVU7.02 · 29%
- Malpractice RVU3.50 · 14%
77
Medicare services in 2024 · #5085 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.
32664 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
Code 32673 represents thoracoscopic thymus removal. It is not the code for sympathetic-chain excision.
No office rate
Code 32663 is for thoracoscopic removal of a lung lobe; 32664 targets thoracic sympathetic nerve tissue.
Compare 32664 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$753.37
Southern Maine →
Office / nonfacility
Unavailable
Facility
$771.07
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32664 billing questions
When should this code be selected instead of 32662?
Use 32664 for thoracoscopic excision of thoracic sympathetic nerve tissue. Code 32662 describes excision of a mediastinal lesion, not a sympathetic-chain operation.
How does this differ from 32673?
Code 32673 is for thoracoscopic thymus removal. Use 32664 when the operative target is thoracic sympathetic nerve tissue.
What documentation supports reporting 32664?
The operative report should describe the thoracoscopic approach, the sympathetic nerve tissue excised, the treated side, and the clinical indication, such as severe primary palmar hyperhidrosis.
How is bilateral surgery reported?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and the other procedure or procedures at 50%.
What are the assistant and co-surgeon payment rules?
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 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.
3,75732661,,Thoracoscopy w/pericard exc,A,,13.00,6.84,NA,6.84,,3.26,23.10,23.10,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75832662,,Thoracoscopy w/mediast exc,A,,14.62,7.49,NA,7.49,,3.66,25.77,25.77,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75932663,,Thoracoscopy w/lobectomy,A,,24.02,9.43,NA,9.43,,6.03,39.48,39.48,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,76032664,,Thoracoscopy w/ th nrv exc,A,,13.92,7.02,NA,7.02,,3.50,24.44,24.44,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,76132665,,Thoracoscop w/esoph musc exc,A,,20.99,8.69,NA,8.69,,5.27,34.95,34.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,76232666,,Thoracoscopy w/wedge resect,A,,14.14,7.42,NA,7.42,,3.56,25.12,25.12,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,76332667,,Thoracoscopy w/w resect addl,A,,2.93,0.58,NA,0.58,,0.73,4.24,4.24,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00