$85.53
32561 identifies the initial treatment day; 32562 is for a subsequent treatment day.
On this page
CMS RVU26D · Effective 2026-10-01
32561 Pleural fibrinolysis Medicare reimbursement rates in Nebraska
Reports initial-day instillation of a fibrinolytic through a chest tube or catheter to help clear a loculated pleural fluid collection. Compare 32561 office and facility rates across CMS payment localities in Nebraska.
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 32561 in Nebraska?
Nebraska 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
$94.18
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$56.26
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Pleural procedure
About 32561: Initial-day pleural fibrinolytic instillation
Reports initial-day instillation of a fibrinolytic through a chest tube or catheter to help clear a loculated pleural fluid collection.
A physician or other qualified practitioner instills a fibrinolytic agent, such as alteplase, through a chest tube or pleural catheter to help break down fibrin in a loculated pleural collection. This treatment may be used for a complex effusion or empyema when fluid is divided by fibrinous septations. It is performed in settings where the patient can receive care through the pleural drain; the code describes the instillation, not placement of the tube or catheter.
Report 32561 for the initial treatment day. For a later treatment day, use the subsequent-day code 32562 rather than reporting another initial-day service. Documentation should identify the pleural indication, the fibrinolytic administered, the catheter route, and the treatment date. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 32561
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.36 · 45%
- Practice expense (office) RVU1.52 · 50%
- Malpractice RVU0.15 · 5%
4.5K
Medicare services in 2024 · #1948 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.
32561 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$254.63
32560 is pleurodesis treatment intended to create pleural adhesion. 32561 instills a fibrinolytic to break down fibrin in a pleural collection.
$288.70
32555 reports image-guided aspiration of pleural fluid. 32561 reports fibrinolytic instillation through a chest tube or catheter.
Compare 32561 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
Nebraska →
Office / nonfacility
$94.18
Facility
$56.26
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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 32561 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
3,738
- Code
- 32561
- Physician work
- 1.36
- Practice expense
- 1.52
- Malpractice
- 0.15
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.36 | × 1.000 | 1.3600 |
| Practice expense | 1.52 | × 0.923 | 1.4030 |
| Malpractice | 0.15 | × 0.378 | 0.0567 |
| Total RVUs | 2.8197 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$94.18
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.36 | 1 |
| Practice expense | 1.52 | 0.923 |
| Malpractice | 0.15 | 0.378 |
(1.36 × 1 + 1.52 × 0.923 + 0.15 × 0.378) × $33.4009 = $94.18
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.36 | 1 |
| Practice expense | 0.29 | 0.923 |
| Malpractice | 0.15 | 0.378 |
(1.36 × 1 + 0.29 × 0.923 + 0.15 × 0.378) × $33.4009 = $56.26
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.
32561 billing questions
When should 32561 be used instead of 32562?
Use 32561 for the initial day of pleural fibrinolytic treatment. Use 32562 for treatment on a subsequent day.
Does 32561 include placing the chest tube?
No. It reports fibrinolytic instillation through a chest tube or catheter, not insertion of that access device.
What should the record support?
Document the pleural condition being treated, the fibrinolytic agent, its administration through the drain, and whether this is the initial or a subsequent treatment day.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 0-day global period affect billing?
Same-day preoperative and postoperative care is included in the procedure. Care on a later date is outside that 0-day global period.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
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.
3,73532556,,Insert cath pleura w/o image,A,,2.44,22.37,,0.54,,0.37,25.18,3.35,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73632557,,Insert cath pleura w/ image,A,,3.04,16.03,,0.50,,0.33,19.40,3.87,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73732560,,Treat pleurodesis w/agent,A,,1.50,6.54,,0.32,,0.23,8.27,2.05,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73832561,,Lyse chest fibrin init day,A,,1.36,1.52,,0.29,,0.15,3.03,1.80,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,73932562,,Lyse chest fibrin subq day,A,,1.21,1.41,,0.27,,0.13,2.75,1.61,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74032601,,Thoracoscopy diagnostic,A,,5.36,1.96,NA,1.96,,1.31,8.63,8.63,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,74132604,,Thoracoscopy wbx sac,A,,8.55,2.65,NA,2.65,,2.15,13.35,13.35,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068