Billing code 32097: Lung nodule biopsyMedicare rate & RVUs in Oklahoma
Report this code for an open thoracic approach that removes a wedge of lung containing a nodule for diagnostic evaluation.
CMS doesn’t publish an office rate for 32097 in Oklahoma.
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 32097 covers
A thoracic surgeon uses an open chest approach to remove a wedge of lung containing a nodule for diagnosis. The specimen is sent for pathologic evaluation; the operative record should establish that the target was a lung nodule and that the wedge was performed through an open approach. This service is typically performed in a hospital operating room.
Select this code for a diagnostic wedge resection of a nodule, rather than biopsy of a lung infiltrate or pleura. Document the target, surgical approach, and diagnostic purpose. The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. 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.
32097 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $722.58 |
How the 32097 rate is calculated
Each of 32097’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 · 32097
RVUs × geographic indexes × conversion factor
Work13.41
13.41 RVUs× 1.000 GPCI
Practice expense6.32
6.32 RVUs× 1.000 GPCI
Malpractice3.32
3.32 RVUs× 1.000 GPCI
Adjusted RVUs
23.0500
Conversion factor
$33.4009
Medicare rate
$769.89
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32097
32097 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32097
Lung nodule 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 · 32097
Lung nodule 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
32097 without 51 · national facility
$769.89
Lung nodule biopsy
32097-51 · Second procedure: 50%
$384.95
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%).
32097 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 32096Lung biopsy
- Choose 32097 for a diagnostic wedge resection of a lung nodule; choose 32096 for biopsy of lung infiltrates.
- 32098Pleural biopsy
- 32098 describes open diagnostic biopsy involving lung or pleura, while 32097 identifies a wedge resection directed at a lung nodule.
- 32607Lung biopsy
- Both address diagnostic sampling of a lung nodule or mass, but 32607 is performed thoracoscopically and 32097 uses an open approach.
- 32505Lung wedge resection
- Use 32097 when the wedge resection is diagnostic; 32505 describes a therapeutic wedge resection.
32097 billing questions
How does this differ from 32096?
Use 32097 for a diagnostic wedge resection directed at a lung nodule. Code 32096 is for diagnostic biopsy of lung infiltrates.
Is this the open code when the surgeon uses thoracoscopy?
No. This code describes an open approach. For a thoracoscopic diagnostic biopsy of a lung nodule or mass, compare 32607.
Does the 90-day global include postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for nodules in both lungs?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction.
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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