No office rate
Choose 32504 when chest-wall reconstruction accompanies apical tumor resection. Choose 32503 when the apical tumor resection includes chest wall but no reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
32504 Apical tumor resection Medicare reimbursement rates in Washington
Reports resection of an apical lung tumor involving the chest wall when the surgeon also reconstructs the chest wall during the operation. Compare 32504 office and facility rates across CMS payment localities in Washington.
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 32504 in Washington?
Washington 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
$1886.00–$2021.53
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 32504: Apical lung tumor resection with reconstruction
Reports resection of an apical lung tumor involving the chest wall when the surgeon also reconstructs the chest wall during the operation.
A thoracic surgeon removes an apical lung tumor, such as a Pancoast tumor, along with involved chest wall, then reconstructs the chest wall during the same operation. The service is performed in an operating room and may involve en bloc removal of tumor and chest-wall structures followed by reconstruction. The reconstruction distinguishes this service from apical tumor resection without reconstruction.
Report this code when the operative documentation supports both apical tumor resection involving the chest wall and chest-wall reconstruction. The reconstruction is part of the coded service. Medicare assigns a 90-day global period, which includes 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 are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 32504
- 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 RVU35.63 · 62%
- Practice expense (office) RVU12.85 · 22%
- Malpractice RVU8.99 · 16%
40
Medicare services in 2024 · #5497 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.
32504 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
32505 describes an initial lung wedge resection. It does not represent apical tumor resection involving the chest wall with reconstruction.
No office rate
32507 is for a diagnostic lung wedge resection. Use 32504 for therapeutic resection of an apical tumor involving the chest wall with reconstruction.
Compare 32504 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$1886.00
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$2021.53
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32504 billing questions
How does this differ from 32503?
Both codes describe apical lung tumor resection that includes chest wall. Use 32504 when chest-wall reconstruction is performed; 32503 describes the procedure without reconstruction.
Is chest-wall reconstruction separately reported?
Reconstruction is included in 32504 when performed as part of the apical tumor resection. The operative report should document the reconstruction.
Can modifier 50 be used for bilateral surgery?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related 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.
3,72032491,,Lung volume reduction,R,,24.61,11.33,NA,11.33,,6.20,42.14,42.14,0,090,0.10,0.76,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72132501,,Repair bronchus add-on,A,,4.56,0.90,NA,0.90,,1.15,6.61,6.61,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72232503,,Resect apical lung tumor,A,,30.95,11.93,NA,11.93,,7.81,50.69,50.69,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72332504,,Resect apical lung tum/chest,A,,35.63,12.85,NA,12.85,,8.99,57.47,57.47,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72432505,,Wedge resect of lung initial,A,,15.36,7.62,NA,7.62,,3.81,26.79,26.79,0,090,0.10,0.76,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72532506,,Wedge resect of lung add-on,A,,2.93,0.58,NA,0.58,,0.72,4.23,4.23,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,72632507,,Wedge resect of lung diag,A,,2.93,0.58,NA,0.58,,0.72,4.23,4.23,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00