Billing code 32504: Apical tumor resectionMedicare rate & RVUs in Nevada
Reports resection of an apical lung tumor involving the chest wall when the surgeon also reconstructs the chest wall during the operation.
CMS doesn’t publish an office rate for 32504 in Nevada.
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 32504 covers
A thoracic surgeon removes an apical lung tumor, such as a Pancoast tumor, along with involved chest wall, then reconstructs the chest wall during the same operation. The service is performed in an operating room and may involve en bloc removal of tumor and chest-wall structures followed by reconstruction. The reconstruction distinguishes this service from apical tumor resection without reconstruction.
Report this code when the operative documentation supports both apical tumor resection involving the chest wall and chest-wall reconstruction. The reconstruction is part of the coded service. Medicare assigns a 90-day global period, which includes 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 others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. 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.
32504 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $1,869.83 |
How the 32504 rate is calculated
Each of 32504’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 · 32504
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 35.63Practice expense 12.85Malpractice 8.99
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32504
32504 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32504
Apical tumor resection
| 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 · 32504
Apical tumor resection
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
32504 without 51 · national facility
$1,919.55
Apical tumor resection
32504-51 · Second procedure: 50%
$959.78
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%).
32504 compared with similar codes
Compare codes
32504 vs 32503 vs 32505 vs 32507: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32503Lung tumor resection
- Choose 32504 when chest-wall reconstruction accompanies apical tumor resection. Choose 32503 when the apical tumor resection includes chest wall but no reconstruction.
- 32505Lung wedge resection
- 32505 describes an initial lung wedge resection. It does not represent apical tumor resection involving the chest wall with reconstruction.
- 32507Lung wedge resection
- 32507 is for a diagnostic lung wedge resection. Use 32504 for therapeutic resection of an apical tumor involving the chest wall with reconstruction.
32504 billing questions
How does this differ from 32503?
Both codes describe apical lung tumor resection that includes chest wall. Use 32504 when chest-wall reconstruction is performed; 32503 describes the procedure without reconstruction.
Is chest-wall reconstruction separately reported?
Reconstruction is included in 32504 when performed as part of the apical tumor resection. The operative report should document the reconstruction.
Can modifier 50 be used for bilateral surgery?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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