32999
No office rateUnlisted px lungs & pleura
Use 32997 when the service is whole-lung lavage. Consider 32999 only when the lung or pleural procedure performed is not accurately represented by a specific listed code.
On this page
CMS RVU26D · Effective 2026-10-01
32997 Lung lavage Medicare reimbursement rates in Vermont
Reports therapeutic washing of an entire lung, typically for pulmonary alveolar proteinosis, using repeated saline instillation and drainage. Compare 32997 office and facility rates across CMS payment localities in Vermont.
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 32997 in Vermont?
Vermont 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
$290.11
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Pulmonary procedure
About 32997: Therapeutic total lung lavage
Reports therapeutic washing of an entire lung, typically for pulmonary alveolar proteinosis, using repeated saline instillation and drainage.
Total lung lavage washes an entire lung to remove accumulated material from the air spaces, most commonly in a patient with pulmonary alveolar proteinosis. In a controlled operating-room setting, the lung being treated is isolated while the other lung is ventilated; warmed saline is introduced and drained in repeated cycles. A thoracic surgeon or pulmonologist typically performs the lavage with anesthesia support. The procedure treats a whole lung rather than a focal lesion or an individual airway.
Report the service when the operative record supports therapeutic lavage of the entire lung, including the indication, side treated, lung-isolation approach, and lavage performed. For bilateral treatment, CMS recognizes modifier 50 and pays the bilateral procedure at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 32997
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.13 · 79%
- Practice expense (office) RVU1.27 · 14%
- Malpractice RVU0.59 · 7%
64
Medicare services in 2024 · #5197 by national volume
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.
32997 compared with similar codes
Office rates for Vermont, from the same CMS release.
$131.10
32960 describes therapeutic pneumothorax. It does not represent saline washing and drainage of an entire lung.
$4,485.85
32994 describes percutaneous cryoablation of a pulmonary tumor. It targets a focal tumor rather than washing an entire lung.
$2,879.80
32998 describes percutaneous radiofrequency ablation of a pulmonary tumor. Use 32997 for therapeutic whole-lung lavage, not focal tumor ablation.
Compare 32997 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
Vermont →
Office / nonfacility
Unavailable
Facility
$290.11
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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 32997 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,810
- Code
- 32997
- Physician work
- 7.13
- Practice expense
- 1.27
- Malpractice
- 0.59
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.13 | × 1.000 | 7.1300 |
| Practice expense | 1.27 | × 0.990 | 1.2573 |
| Malpractice | 0.59 | × 0.506 | 0.2985 |
| Total RVUs | 8.6858 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$290.11
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.13 | 1 |
| Practice expense | 1.27 | 0.99 |
| Malpractice | 0.59 | 0.506 |
(7.13 × 1 + 1.27 × 0.99 + 0.59 × 0.506) × $33.4009 = $290.11
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.
32997 billing questions
When is 32997 appropriate instead of a lung tumor ablation code?
Use 32997 for therapeutic washing of an entire lung, typically for pulmonary alveolar proteinosis. Lung tumor ablation codes describe treatment directed at a focal tumor, not diffuse material in the air spaces.
How should bilateral lavage be reported?
When both lungs are treated, report the bilateral service with modifier 50. CMS pays the bilateral procedure at 150%.
What documentation supports 32997?
Document the therapeutic indication, the side or sides treated, lung isolation, and the lavage performed. The record should make clear that the service involved whole-lung washing rather than a focal airway or tumor procedure.
How does the multiple-procedure reduction affect 32997?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and other procedures at 50%. Which procedure receives the reduction depends on the relative values of the services reported.
Can an assistant or co-surgeon be reported for this procedure?
Medicare does not pay an assistant at surgery for 32997. Co-surgeons and team surgery are not permitted.
What care is included in the global period?
The 0-day global period includes same-day preoperative and 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.
3,8073294F,,Grp b strep screening docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,80832960,,Therapeutic pneumothorax,A,,1.79,2.08,,0.52,,0.15,4.02,2.46,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,80932994,,Ablate pulm tumor perq crybl,A,,8.80,126.26,,1.60,,1.00,136.06,11.40,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81032997,,Total lung lavage,A,,7.13,1.27,NA,1.27,,0.59,8.99,8.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81132998,,Ablate pulm tumor perq rf,A,,8.80,77.68,,1.58,,1.02,87.50,11.40,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81232999,,Unlisted px lungs & pleura,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8133300F,,Ajcc stage docd b/4 thxpy,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817