No office rate
Both address bullae excision or plication, but 32655 uses a thoracoscopic approach; 32140 is the open thoracotomy service.
On this page
CMS RVU26D · Effective 2026-10-01
32140 Bullectomy Medicare reimbursement rates in Tennessee
Reports open thoracotomy to remove or plicate pulmonary bullae, commonly for bullous lung disease associated with persistent air leak or pneumothorax. Compare 32140 office and facility rates across CMS payment localities in Tennessee.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 32140 in Tennessee?
Tennessee has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$867.00
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Thoracic surgery
About 32140: Open thoracotomy bullectomy and plication
Reports open thoracotomy to remove or plicate pulmonary bullae, commonly for bullous lung disease associated with persistent air leak or pneumothorax.
A thoracic surgeon uses an open chest approach to excise or plicate pulmonary bullae, often in patients with bullous emphysema or a pneumothorax related to a bulla. The operation includes the pleural work performed as part of this service. It is distinct from taking a diagnostic sample or removing a lung lobe, and is generally performed in an operating room under general anesthesia.
Report the code when the operative note supports open thoracotomy with bullae excision or plication. Documentation should identify the bullae treated, the approach, and the operative work performed. The CMS global period 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 reduction. Report the operation as performed rather than using modifier 50 for bilateral work. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32140
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.24 · 57%
- Practice expense (office) RVU8.28 · 29%
- Malpractice RVU4.08 · 14%
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.
32140 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
32505 describes an open therapeutic wedge resection for a lung lesion. Use 32140 for open excision or plication of bullae.
No office rate
32480 is a lobectomy, removing a lung lobe. 32140 treats bullae without describing lobar removal.
No office rate
32100 is limited thoracotomy for lung or pleural biopsy; 32140 is therapeutic bullae surgery rather than diagnostic sampling.
Compare 32140 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Tennessee →
Office / nonfacility
Unavailable
Facility
$867.00
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 32140 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
3,694
- Code
- 32140
- Physician work
- 16.24
- Practice expense
- 8.28
- Malpractice
- 4.08
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.24 | × 1.000 | 16.2400 |
| Practice expense | 8.28 | × 0.909 | 7.5265 |
| Malpractice | 4.08 | × 0.537 | 2.1910 |
| Total RVUs | 25.9575 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$867.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.24 | 1 |
| Practice expense | 8.28 | 0.909 |
| Malpractice | 4.08 | 0.537 |
(16.24 × 1 + 8.28 × 0.909 + 4.08 × 0.537) × $33.4009 = $867.00
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
32140 billing questions
When is this code appropriate instead of a lung biopsy code?
Use it for open thoracotomy with excision or plication of bullae, not for an operation whose purpose is only to obtain a diagnostic lung sample.
Is pleural work performed during the bullectomy separately reported?
Pleural procedures performed as part of this service are included. Do not separately report that included pleural work.
Should modifier 50 be used for bullae treated on both sides?
No. Report the procedure performed without modifier 50; CMS does not provide a bilateral adjustment for this code.
Can an assistant surgeon be reported?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.
How does the multiple-procedure reduction affect another operation in the same session?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,69132110,,Explore/repair chest,A,,24.65,11.04,NA,11.04,,6.10,41.79,41.79,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69232120,,Re-exploration of chest,A,,14.03,7.90,NA,7.90,,3.49,25.42,25.42,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69332124,,Explore chest free adhesions,A,,15.06,8.12,NA,8.12,,3.74,26.92,26.92,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69432140,,Removal of lung lesion(s),A,,16.24,8.28,NA,8.28,,4.08,28.60,28.60,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69532141,,Remove/treat lung lesions,A,,26.50,9.84,NA,9.84,,6.58,42.92,42.92,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69632150,,Removal of lung lesion(s),A,,16.40,8.73,NA,8.73,,4.08,29.21,29.21,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,69732151,,Remove lung foreign body,A,,16.52,8.33,NA,8.33,,4.15,29.00,29.00,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780