Billing code 32560: Chemical pleurodesisMedicare rate & RVUs in Texas
Reports instillation of a pleurodesis agent through a chest tube or catheter to treat conditions such as recurrent pneumothorax or pleural effusion.
Medicare pays $256.02–$288.12 for 32560 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 32560 covers
A clinician instills an agent through an existing chest tube or pleural catheter to promote adhesion of the pleural layers and reduce recurrent fluid or air accumulation. Common situations include recurrent pneumothorax and recurrent pleural effusion, including effusion associated with malignancy. Thoracic surgeons and pulmonologists commonly perform the service in a hospital or other facility setting.
Select this code for the pleurodesis instillation, not simply for placing the drain. Documentation should identify the indication, agent, route through the chest tube or catheter, and treated side. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur 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 for this service. Assistant-at-surgery services are not paid, and co-surgeons and team surgery 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 32560 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$256.02 to $288.12
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $288.12 | $68.32 |
| Beaumont | $256.02 | $66.96 |
| Brazoria | $272.97 | $67.09 |
| Dallas | $274.71 | $67.79 |
| Fort Worth | $272.63 | $67.78 |
| Galveston | $273.78 | $67.48 |
| Houston | $277.99 | $71.69 |
| Rest Of Texas | $264.34 | $67.18 |
How the 32560 rate is calculated
Each of 32560’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 · 32560
RVUs × geographic indexes × conversion factor
Work1.50
1.50 RVUs× 1.000 GPCI
Practice expense6.54
6.54 RVUs× 1.000 GPCI
Malpractice0.23
0.23 RVUs× 1.000 GPCI
Adjusted RVUs
8.2700
Conversion factor
$33.4009
Medicare rate
$276.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32560
The CMS indicators that decide how 32560 is paid alongside other services.
CMS payment indicators · 32560
Chemical pleurodesis
| 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) | 1 | Not paid (statutory restriction). |
| 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
32560 without 51 · national office
$276.23
Chemical pleurodesis
32560-51 · Second procedure: 50%
$138.12
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%).
32560 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 32650Pleurodesis
- 32560 describes agent instillation through a chest tube or catheter; 32650 describes pleurodesis performed thoracoscopically.
- 32561Pleural fibrinolysis
- 32561 is for intrapleural fibrinolytic treatment, not instillation of an agent to create pleural adhesion.
- 32562Pleural fibrinolysis
- 32562 reports a subsequent-day fibrinolytic treatment; it is not a subsequent-day code for pleurodesis.
- 32551Chest tube
- 32551 reports chest tube insertion. Use 32560 for the pleurodesis agent instilled through a tube or catheter.
32560 billing questions
When should 32560 be selected instead of thoracoscopic pleurodesis?
Use 32560 when the pleurodesis agent is instilled through a chest tube or catheter. Thoracoscopic pleurodesis uses an operative thoracoscopic approach and is reported with 32650.
Does 32560 include placement of the chest tube?
The service is the agent instillation through a chest tube or catheter. If a drain is placed during the encounter, document that procedure separately and assess its reporting under the applicable coding rules.
Can modifier 50 be reported for bilateral treatment?
No. Modifier 50 is inappropriate for this service under the CMS facts for this code.
What documentation supports 32560?
Record the clinical indication, the agent instilled, use of a chest tube or catheter as the route, and the side treated.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How are other procedures 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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