Billing code 32820: Chest wall reconstructionMedicare rate & RVUs in Texas
Report major reconstruction to restore chest-wall structure after substantial injury-related damage, rather than for a limited fistula closure or focal lung hernia repair.
CMS doesn’t publish an office rate for 32820 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 32820 covers
This service rebuilds a substantially damaged chest wall, commonly after trauma that has left a large defect or disrupted the chest wall’s structural support. A thoracic surgeon typically performs the reconstruction in an operating room, restoring support and coverage; the repair may involve graft or prosthetic material. The work is more extensive than closing a drainage site or repairing a focal lung hernia.
Select the code when the operative report supports major reconstruction, describing the injury, defect, structures rebuilt, and materials used. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 32820 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 | $1,317.61 |
| Beaumont | Unavailable | $1,265.20 |
| Brazoria | Unavailable | $1,275.94 |
| Dallas | Unavailable | $1,292.96 |
| Fort Worth | Unavailable | $1,291.37 |
| Galveston | Unavailable | $1,285.53 |
| Houston | Unavailable | $1,386.02 |
| Rest Of Texas | Unavailable | $1,275.93 |
How the 32820 rate is calculated
Each of 32820’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 · 32820
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.95Practice expense 11.90Malpractice 5.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 32820
32820 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 32820
Chest wall reconstruction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 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. |
| Split (54/55/56) | 0.10/0.76/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 32820
Chest wall reconstruction
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
32820 without 51 · national facility
$1,313.99
Chest wall reconstruction
32820-51 · Second procedure: 50%
$657.00
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%).
32820 compared with similar codes
Compare codes
32820 vs 32800 vs 32810 vs 32815: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 32800Lung hernia repair
- 32800 addresses a lung hernia protruding through the chest wall. Use 32820 when the operative work is major reconstruction of the chest wall itself.
- 32810Chest closure
- 32810 is for closing the chest wall after drainage. It does not describe major reconstruction of a substantially damaged chest wall.
- 32815Fistula closure
- 32815 addresses closure of a bronchial fistula. Choose 32820 when the principal work is rebuilding the chest wall rather than closing the fistula.
32820 billing questions
When is this more appropriate than a limited chest-wall repair?
Use 32820 for major reconstruction of a substantial chest-wall defect, such as injury-related structural damage. A focal lung hernia repair or closure after drainage has a more specific code.
What documentation supports reporting 32820?
The operative report should establish the cause and extent of the defect, identify the chest-wall structures reconstructed, and describe the reconstructive work and materials used.
Should modifier 50 be appended for reconstruction on both sides?
No. Modifier 50 is inappropriate for this service.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
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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