Billing code 32096: Lung biopsyMedicare rate & RVUs in Nebraska
Reports an open surgical wedge biopsy of lung tissue with infiltrative changes when tissue is needed to establish a diagnosis.
CMS doesn’t publish an office rate for 32096 in Nebraska.
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 32096 covers
The surgeon opens the chest and removes wedge samples from lung tissue showing infiltrative changes for diagnostic examination. A thoracic surgeon typically performs this operation in a hospital operating room when tissue is needed for pathologic evaluation, and sometimes for microbiologic studies. The target is an infiltrate rather than a discrete lung nodule or pleural tissue.
Select this code based on the tissue sampled and the open approach; document the infiltrative target, the biopsy performed, and the diagnostic purpose. It has 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 are subject to the standard 50% reduction. Bilateral adjustment does not apply, so modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires 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.
32096 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $679.24 |
How the 32096 rate is calculated
Each of 32096’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 · 32096
RVUs × geographic indexes × conversion factor
Work13.41
13.41 RVUs× 1.000 GPCI
Practice expense6.14
6.14 RVUs× 1.000 GPCI
Malpractice3.33
3.33 RVUs× 1.000 GPCI
Adjusted RVUs
22.8800
Conversion factor
$33.4009
Medicare rate
$764.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32096
32096 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32096
Lung biopsy
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 32096
Lung biopsy
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 51 · payment effect
With and without the modifier
32096 without 51 · national facility
$764.21
Lung biopsy
32096-51 · Second procedure: 50%
$382.11
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
32096 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 32097Lung nodule biopsy
- Choose 32096 for infiltrative lung tissue and 32097 for a discrete lung nodule. The target documented by the surgeon distinguishes these open biopsy codes.
- 32098Pleural biopsy
- 32096 samples lung tissue; 32098 samples pleura. Identify the anatomic tissue submitted for biopsy.
- 32607Lung biopsy
- Both address biopsy of a lung infiltrate, but 32096 is the open approach and 32607 is the thoracoscopic approach.
- 32408Core biopsy
- 32408 describes percutaneous core needle sampling of lung or mediastinum; 32096 describes an open surgical wedge biopsy of lung tissue.
32096 billing questions
When is 32096 selected instead of 32097?
Use 32096 when the open biopsy targets lung tissue with infiltrative changes. Code 32097 is for a discrete lung nodule target.
Does this code describe a pleural biopsy?
No. It describes biopsy of lung tissue; 32098 is the related open biopsy code for pleural tissue.
Can modifier 50 be reported for bilateral lung biopsies?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included in the global period?
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?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires 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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