No office rate
32661 is for excising a pericardial cyst or mass; 32659 is for thoracoscopic drainage of the pericardial sac.
On this page
CMS RVU26D · Effective 2026-10-01
32661 Pericardial excision Medicare reimbursement rates in Virginia
Reports thoracoscopic surgical removal of a pericardial cyst or mass, rather than drainage alone or a biopsy of another thoracic structure. Compare 32661 office and facility rates across CMS payment localities in Virginia.
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 32661 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$735.66–$847.98
2 of 2 localities have a supported rate.
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.
Thoracic surgery
About 32661: Thoracoscopic pericardial lesion excision
Reports thoracoscopic surgical removal of a pericardial cyst or mass, rather than drainage alone or a biopsy of another thoracic structure.
Code 32661 describes an operation in which the surgeon uses a thoracoscope to inspect the pericardium and excise a cyst or mass. It is typically performed by a thoracic or cardiothoracic surgeon in an operating room, often using a video-assisted thoracoscopic approach. The operative report should establish that the lesion arises from the pericardium and was excised; a procedure limited to draining the pericardial sac or sampling pleura is a different service.
Report the code for the thoracoscopic excision, and document the lesion’s location, the approach, and the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 32661
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.00 · 56%
- Practice expense (office) RVU6.84 · 30%
- Malpractice RVU3.26 · 14%
79
Medicare services in 2024 · #5060 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.
32661 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Choose based on the lesion’s origin: 32661 covers a pericardial lesion, while 32662 covers a mediastinal cyst, tumor, or mass.
No office rate
32661 removes a pericardial cyst or mass. Code 32609 is for thoracoscopic biopsy of pleura, not excision of a pericardial lesion.
Compare 32661 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$847.98
Virginia →
Office / nonfacility
Unavailable
Facility
$735.66
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32661 billing questions
How is this different from 32659?
32661 is for thoracoscopic excision of a pericardial cyst or mass. Code 32659 describes thoracoscopic drainage of the pericardial sac.
When would 32662 be considered instead?
Use 32662 when the excised cyst, tumor, or mass is mediastinal rather than pericardial. The operative report should identify the structure of origin.
Does this code include drainage of the pericardial sac?
The service represented by 32661 is excision of a pericardial cyst or mass. Drainage alone is represented by 32659.
Can modifier 50 be appended for bilateral work?
No. Modifier 50 is inappropriate for this code.
What global period and multiple-procedure rules apply?
The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
What should the operative report document?
Document that the lesion is pericardial, the thoracoscopic approach, and the excision performed. If co-surgeon payment is claimed, supporting documentation is required.
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.
3,75432658,,Thoracoscopy w/sac fb remove,A,,11.42,6.53,NA,6.53,,2.87,20.82,20.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75532659,,Thoracoscopy w/sac drainage,A,,11.64,6.90,NA,6.90,,2.91,21.45,21.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,7563265F,,Rna tstng hepc vir ord/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
3,75732661,,Thoracoscopy w/pericard exc,A,,13.00,6.84,NA,6.84,,3.26,23.10,23.10,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75832662,,Thoracoscopy w/mediast exc,A,,14.62,7.49,NA,7.49,,3.66,25.77,25.77,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,75932663,,Thoracoscopy w/lobectomy,A,,24.02,9.43,NA,9.43,,6.03,39.48,39.48,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,76032664,,Thoracoscopy w/ th nrv exc,A,,13.92,7.02,NA,7.02,,3.50,24.44,24.44,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00