CPT code 32400: Pleural biopsy2026 Medicare rate & RVUs in Virginia
Reports percutaneous needle sampling of pleural tissue when a clinician needs a tissue diagnosis from the lining around the lungs.
Medicare pays $162.82–$188.43 for 32400 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. Which amount applies depends on the service address.
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 32400 covers
A clinician passes a needle through the chest wall to obtain pleural tissue for diagnostic evaluation. Pulmonologists, interventional radiologists, and thoracic surgeons may perform the procedure, often in a hospital setting. The target is the pleura, not a lung nodule or mediastinal mass; aspiration of pleural fluid alone is a different service.
Report this code when the needle biopsy samples pleural tissue, and document the target, percutaneous approach, and reason tissue was needed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are 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 32400 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $188.43 | $77.87 |
| Virginia | $162.82 | $70.56 |
How the 32400 rate is calculated
Each of 32400’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 · 32400
RVUs × geographic indexes × conversion factor
Work1.72
1.72 RVUs× 1.000 GPCI
Practice expense3.08
3.08 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
4.9800
Conversion factor
$33.4009
Medicare rate
$166.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 32400
The CMS indicators that decide how 32400 is paid alongside other services.
CMS payment indicators · 32400
Pleural biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
32400 without 51 · national office
$166.34
Pleural biopsy
32400-51 · Second procedure: 50%
$83.17
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%).
32400 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 32408Core biopsy
- Choose 32400 for pleural tissue sampled percutaneously; choose 32408 when the needle core biopsy targets lung or mediastinal tissue.
- 32609Pleural biopsy
- This code describes percutaneous needle sampling of pleura. Code 32609 is used when pleural biopsy is performed during diagnostic thoracoscopy.
- 32555Thoracentesis
- Code 32555 describes image-guided aspiration of pleural fluid. Use 32400 when the procedure obtains pleural tissue rather than fluid.
32400 billing questions
How do I distinguish this from 32408?
Use 32400 for needle sampling of pleural tissue. Code 32408 describes percutaneous core biopsy of lung or mediastinal tissue.
Can I report this for pleural fluid removal?
No. This code is for tissue sampling. Thoracentesis codes describe pleural fluid aspiration.
Is modifier 50 appropriate for a biopsy on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What documentation supports reporting the biopsy?
Document that the target was pleura, that tissue was obtained by a percutaneous needle approach, and the clinical reason for tissue sampling.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
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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