32036 Empyema surgery Medicare reimbursement rates in Virginia

A thoracic surgeon uses this operation to manage chronic empyema, a persistent infected collection in the pleural space. The surgeon opens the chest wall to drain the cavity and brings in a vascularized flap, such as muscle or omentum, to occupy the space. The service is generally performed in a hospital operating room; the flap work distinguishes it from drainage through a chest tube or an operation involving rib resection without a flap.

Select the code when the operative report supports chronic empyema treatment with flap placement, not merely pleural drainage. Document the affected side, the chronic pleural infection, and the flap tissue and operative work. Medicare classifies this as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.