Billing code 32225: Lung decorticationMedicare rate & RVUs in Ohio

Reports open surgical removal of part of a fibrous covering that restricts lung expansion, commonly for a trapped lung after pleural disease.

CMS RVU26DEffective Oct 1, 20261 payment locality421 Medicare services in 2024

CMS doesn’t publish an office rate for 32225 in Ohio.

—Office (non-facility)
$934.66Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 32225 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 32225 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 32225 covers

The surgeon opens the chest and removes part of the fibrous peel constricting the lung, allowing the affected portion to expand more freely. This operation may be used for a trapped lung associated with chronic pleural inflammation, empyema, or retained blood. Thoracic surgeons typically perform it in a hospital operating room. The code represents partial pulmonary decortication through an open approach; video-assisted thoracoscopic decortication is represented by a different code family.

Choose partial rather than complete decortication based on the extent of peel removed, not simply the underlying diagnosis. The operative report should describe the affected lung, the fibrous restriction, the portion released, and the open approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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.

32225 in Ohio

32225 office and facility rates by payment locality
Payment localityOfficeFacility
OhioUnavailable$934.66

How the 32225 rate is calculated

Each of 32225’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 · 32225

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.33Practice expense 8.27Malpractice 4.07

28.6700 adjusted RVUs×$33.4009 conversion factor=$957.60

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 32225

32225 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32225

Lung decortication

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.76/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 32225

Lung decortication

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

32225 without 50 · national facility

$957.60

Lung decortication

32225-50 · Bilateral: 150%

$1,436.40

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

32225 compared with similar codes

Compare codes

32225 vs 32220 vs 32215 vs 32651 vs 32652: national Medicare rates

Swap in your local Medicare rate.

  • 32225
    Lung decortication · 16.33 wRVU
    —
  • 32220
    Lung decortication · 25.98 wRVU
    —
  • 32215
    Pleurectomy · 12.72 wRVU
    —
  • 32651
    Thoracoscopic decortication · 18.31 wRVU
    —
  • 32652
    Thoracoscopic decortication · 28.4 wRVU
    —

How to choose

32220Lung decortication
Both are open pulmonary decortication; 32225 is for partial release, while 32220 represents complete decortication.
32215Pleurectomy
32215 concerns removal of parietal pleura. Code 32225 releases the lung by removing a constricting fibrous peel from its surface.
32651Thoracoscopic decortication
Both represent partial pulmonary decortication, but 32651 is for a thoracoscopic operation; 32225 is the open approach.
32652Thoracoscopic decortication
32652 describes complete thoracoscopic pulmonary decortication. Code 32225 describes partial decortication through an open approach.

32225 billing questions

How does 32225 differ from 32220?

Both describe open pulmonary decortication. Use 32225 when the surgeon releases part of the lung; 32220 represents complete decortication.

When is a thoracoscopic decortication code used instead?

Use the thoracoscopic code that matches the extent when the operation is performed by video-assisted thoracoscopy rather than an open thoracotomy. Codes 32651 and 32652 distinguish partial from complete decortication.

Can partial and complete decortication both be reported for the same lung in one operation?

Do not report both to describe the overall extent of decortication at the same site. Select the code that reflects the operation performed.

What documentation supports 32225?

Document the fibrous restriction, the lung area released, the extent of peel removed, and that the surgeon used an open approach.

How are bilateral procedures and assistant services handled?

CMS pays bilateral reporting with modifier 50 at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation.

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
RVUs for 32225PPRRVU2026_Oct_nonQPP.csv, line 3,706 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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