Billing code 32445: PneumonectomyMedicare rate & RVUs in Utah

Reports an extrapleural pneumonectomy, an extensive operation removing a lung with extrapleural dissection, most often for diffuse malignant pleural disease.

CMS RVU26DEffective Oct 1, 20261 payment locality

CMS doesn’t publish an office rate for 32445 in Utah.

—Office (non-facility)
$3,200.02Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 32445 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 32445 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 32445 covers

This code describes an extrapleural pneumonectomy: removal of an entire lung through dissection outside the pleural lining. Thoracic surgeons most often perform it in a hospital operating room for extensive pleural malignancy, particularly diffuse malignant pleural mesothelioma. The operative report should establish that the surgeon performed an extrapleural pneumonectomy, not simply a conventional pneumonectomy with pleural dissection.

Select the code from the documented operation and extent of resection; a complete lung removal alone is not enough to establish the extrapleural approach. The 90-day global period includes the day-before preoperative visit and 90 days of related 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% multiple procedure reduction. Modifier 50 is inappropriate for this code. 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.

32445 in Utah

32445 office and facility rates by payment locality
Payment localityOfficeFacility
UtahUnavailable$3,200.02

How the 32445 rate is calculated

Each of 32445’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 · 32445

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 62.24Practice expense 20.72Malpractice 15.69

98.6500 adjusted RVUs×$33.4009 conversion factor=$3,295.00

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 32445

32445 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 32445

Pneumonectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.76/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 32445

Pneumonectomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

32445 without 51 · national facility

$3,295.00

Pneumonectomy

32445-51 · Second procedure: 50%

$1,647.50

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%).

When to use modifier 51

32445 compared with similar codes

Compare codes

32445 vs 32440 vs 32442 vs 32480: national Medicare rates

Swap in your local Medicare rate.

  • 32445
    Pneumonectomy · 62.24 wRVU
    —
  • 32440
    Pneumonectomy · 26.6 wRVU
    —
  • 32442
    Pneumonectomy · 55.06 wRVU
    —
  • 32480
    Lung resection · 25.17 wRVU
    —

How to choose

32440Pneumonectomy
Use 32445 for an extrapleural pneumonectomy. Use 32440 for pneumonectomy when the operative documentation does not establish the extrapleural procedure.
32442Pneumonectomy
Code 32442 describes sleeve pneumonectomy, distinguished by the sleeve resection technique. Code 32445 identifies the extrapleural pneumonectomy.
32480Lung resection
Code 32480 is for partial lung removal. Code 32445 is for an extrapleural operation removing an entire lung.

32445 billing questions

How does this differ from 32440?

Report 32445 when the operative documentation supports an extrapleural pneumonectomy. Code 32440 describes pneumonectomy without that extrapleural distinction.

What documentation supports 32445?

The operative report should identify the extrapleural pneumonectomy and describe the dissection and lung removal. A diagnosis of pleural malignancy alone does not establish the procedure performed.

Can modifier 50 be used for bilateral surgery?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

How does the global period affect postoperative billing?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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
RVUs for 32445PPRRVU2026_Oct_nonQPP.csv, line 3,714 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 32445 pays in Utah?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 32445 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →