Billing code 32608: Thoracoscopic biopsyMedicare rate & RVUs in Oregon
Reports surgical thoracoscopy to obtain biopsy tissue from a pulmonary nodule or mass when a diagnostic sample is needed.
CMS doesn’t publish an office rate for 32608 in Oregon.
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 32608 covers
This service involves using a thoracoscope to locate and sample a nodule or mass in the lung. Thoracic surgeons commonly perform it in the operating room when imaging has identified a lung lesion that needs tissue diagnosis. The biopsy specimen is submitted for examination; this code describes sampling the lung lesion, not removing it by wedge resection.
Select this code when the operative report supports biopsy of a pulmonary nodule or mass, rather than biopsy of an infiltrate, pleura, or mediastinal structure. Document the target and the biopsy performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment are 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.
Where 32608 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $350.60 |
| Rest Of Oregon | Unavailable | $336.18 |
How the 32608 rate is calculated
Each of 32608’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 · 32608
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.67Practice expense 2.23Malpractice 1.67
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32608
The CMS indicators that decide how 32608 is paid alongside other services.
CMS payment indicators · 32608
Thoracoscopic biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
32608 without 51 · national facility
$353.05
Thoracoscopic biopsy
32608-51 · Second procedure: 50%
$176.53
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%).
32608 compared with similar codes
Compare codes
32608 vs 32607 vs 32609 vs 32601 vs 32668: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32607Lung biopsy
- 32608 is for biopsy of a pulmonary nodule or mass; 32607 is for biopsy of a lung infiltrate.
- 32609Pleural biopsy
- 32608 samples a lung nodule or mass, while 32609 describes thoracoscopic biopsy of pleura.
- 32601Diagnostic thoracoscopy
- 32601 describes diagnostic thoracoscopy; 32608 is the more specific service when the surgeon biopsies a pulmonary nodule or mass.
- 32668Thoracoscopic wedge
- Choose 32668 when the surgeon performs a diagnostic wedge resection. Code 32608 describes biopsy sampling rather than wedge resection.
32608 billing questions
When should 32608 be chosen over 32607?
Use 32608 for biopsy of a pulmonary nodule or mass. Code 32607 describes biopsy of a lung infiltrate.
How does 32608 differ from a diagnostic wedge resection?
32608 represents biopsy sampling of a nodule or mass. When the surgeon performs a diagnostic wedge resection, consider 32668 instead.
Is same-day preoperative or postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can modifier 50 be used for nodules in both lungs?
No. Modifier 50 is inappropriate for this descriptor and anatomy; document the biopsy site or sites and the procedure performed.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when the record documents medical necessity. Co-surgeon and team-surgery payment are not permitted.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures 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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