Billing code 32674: Node dissectionMedicare rate & RVUs in Oregon
Reports thoracoscopic mediastinal and regional lymph node dissection performed with a qualifying lung resection, commonly for oncologic staging.
CMS doesn’t publish an office rate for 32674 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 32674 covers
This add-on represents thoracoscopic removal of mediastinal and regional lymph nodes, often performed by a thoracic surgeon during resection of a lung malignancy for nodal staging. The surgeon identifies and removes lymphatic tissue from the relevant mediastinal and regional areas through the thoracoscopic approach. The service is typically performed in the operating room as part of a lung resection, rather than as a stand-alone procedure.
Report 32674 with an eligible primary thoracoscopic resection, such as lobectomy, segmentectomy, bilobectomy, or pneumonectomy, when the lymph node dissection is performed. The operative report should support that nodal dissection occurred and describe the relevant nodal areas addressed; a lung resection alone does not establish that this additional service was performed. CMS treats 32674 as an add-on code: it is billed only with a primary procedure, and its payment is included within that procedure’s global period.
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 32674 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $191.83 |
| Rest Of Oregon | Unavailable | $185.17 |
How the 32674 rate is calculated
Each of 32674’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 · 32674
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.02Practice expense 0.81Malpractice 1.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32674
The CMS indicators that decide how 32674 is paid alongside other services.
CMS payment indicators · 32674
Node dissection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
32674 without 80 · national facility
$195.40
Node dissection
32674-80 · Assistant: 16%
$31.26
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
32674 compared with similar codes
Compare codes
32674 vs 32662 vs 32663 vs 32669 vs 32668: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32662Mediastinal excision
- 32662 reports thoracoscopic excision of a mediastinal lesion. Use 32674 for lymph node dissection performed with a qualifying primary procedure.
- 32663Thoracoscopic lobectomy
- 32663 reports the thoracoscopic lobectomy. Add 32674 only when mediastinal and regional lymph node dissection is also performed.
- 32669Lung resection
- 32669 reports thoracoscopic segmentectomy. It is the primary resection code; 32674 represents accompanying lymph node dissection.
- 32668Thoracoscopic wedge
- 32668 reports a thoracoscopic diagnostic wedge resection. 32674 instead captures lymph node dissection with a qualifying primary procedure.
32674 billing questions
Can 32674 be reported by itself?
No. It is an add-on code and must be billed with a qualifying primary procedure, such as a thoracoscopic lobectomy or segmentectomy.
Which primary procedures are commonly paired with 32674?
It is commonly reported with thoracoscopic lobectomy, segmentectomy, bilobectomy, or pneumonectomy when mediastinal and regional lymph node dissection is also performed.
Does the lung resection alone support reporting 32674?
No. The operative documentation should support that lymph node dissection was performed, with the relevant nodal areas addressed.
How does 32674 differ from 32662?
32674 reports lymph node dissection performed with a primary thoracoscopic procedure. 32662 describes thoracoscopic excision of a mediastinal lesion, not lymphadenectomy.
Does 32674 have a separate global period?
CMS payment for this add-on is within the global period of the primary procedure with which it is billed.
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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