Billing code 32668: Thoracoscopic wedgeMedicare rate & RVUs in Texas
Reports each additional lung wedge resection performed for diagnostic sampling during thoracoscopy, beyond the initial resection, with a qualifying primary procedure.
CMS doesn’t publish an office rate for 32668 in Texas.
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 32668 covers
A thoracic surgeon uses thoracoscopy to remove an additional wedge-shaped portion of lung for diagnostic examination, often when more than one nodule or area requires tissue sampling. The specimen is submitted for pathology. This code describes an additional diagnostic resection, not the initial wedge or a wedge performed therapeutically to remove a lesion. The service is typically performed in an operating room with the patient under anesthesia.
Report this add-on code only with a qualifying primary thoracoscopic procedure; it is commonly paired with diagnostic thoracoscopy for biopsy of a lung nodule or mass, such as 32608. The operative report should establish that an additional diagnostic wedge was actually resected, rather than simply biopsied or included in a therapeutic wedge procedure. CMS treats payment as part of the primary procedure’s global period, so this code is paid only when reported with the primary procedure and within that 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 32668 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 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $140.51 |
| Beaumont | Unavailable | $138.45 |
| Brazoria | Unavailable | $137.20 |
| Dallas | Unavailable | $139.29 |
| Fort Worth | Unavailable | $139.41 |
| Galveston | Unavailable | $138.40 |
| Houston | Unavailable | $151.77 |
| Rest Of Texas | Unavailable | $138.58 |
How the 32668 rate is calculated
Each of 32668’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 · 32668
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.93Practice expense 0.59Malpractice 0.73
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32668
The CMS indicators that decide how 32668 is paid alongside other services.
CMS payment indicators · 32668
Thoracoscopic wedge
| 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
32668 without 80 · national facility
$141.95
Thoracoscopic wedge
32668-80 · Assistant: 16%
$22.71
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
32668 compared with similar codes
Compare codes
32668 vs 32608 vs 32667 vs 32666: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32608Thoracoscopic biopsy
- 32608 reports the primary thoracoscopic biopsy of a lung nodule or mass. 32668 reports each additional diagnostic lung wedge resection with a qualifying primary procedure.
- 32667Lung wedge resection
- 32667 is for each additional therapeutic wedge resection; 32668 is for an additional wedge resection performed for diagnostic sampling.
- 32666Lung wedge resection
- 32666 reports the initial therapeutic wedge resection and includes diagnostic wedge resection when performed. 32668 applies to an additional diagnostic wedge, not the therapeutic resection itself.
32668 billing questions
When should 32668 be reported instead of 32608?
Use 32608 for the primary thoracoscopic biopsy of a lung nodule or mass. Report 32668 for each additional diagnostic lung wedge resection when the primary procedure and documentation support the add-on service.
Can 32668 be billed by itself?
No. CMS identifies it as an add-on code, so it must be reported with a primary procedure and is paid within that procedure’s global period.
How does 32668 differ from 32667?
32668 describes an additional wedge resection for diagnostic sampling. 32667 describes each additional therapeutic wedge resection.
Does a diagnostic wedge performed during therapeutic resection support 32668?
A diagnostic wedge included with a therapeutic wedge procedure is not separately reported as an additional diagnostic resection. The operative report should distinguish a separately performed additional diagnostic wedge from tissue removed as part of therapeutic resection.
What documentation supports reporting an additional unit?
Document the additional diagnostic wedge resection, the lung site or lesion sampled, and the reason for obtaining the additional specimen. The record should distinguish it from the initial biopsy or wedge and from a therapeutic resection.
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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