Billing code 39561: Diaphragm resectionMedicare rate & RVUs in Washington
Report 39561 when diaphragm tissue is removed and the resulting defect requires complex reconstruction, such as closure with a graft.
CMS doesn’t publish an office rate for 39561 in Washington.
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 39561 covers
Code 39561 describes removal of diaphragm tissue followed by complex repair of the defect, such as reconstruction using a graft. It is most often encountered during a major operation when a tumor or other diseased tissue involves the diaphragm. Thoracic or abdominal surgeons typically perform the work in a hospital operating room. The complex reconstruction distinguishes this service from a resection that can be repaired simply.
Choose this code when the operative report supports both diaphragm resection and complex repair; document the resection and how the defect was reconstructed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code's descriptor and anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery payment is 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 39561 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,207.93 |
| Seattle (King Cnty) | Unavailable | $1,311.09 |
How the 39561 rate is calculated
Each of 39561’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 · 39561
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.49Practice expense 12.01Malpractice 4.96
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 39561
39561 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 39561
Diaphragm resection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 39561
Diaphragm resection
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
39561 without 51 · national facility
$1,217.80
Diaphragm resection
39561-51 · Second procedure: 50%
$608.90
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%).
39561 compared with similar codes
Compare codes
39561 vs 39560 vs 39501 vs 39540: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 39560Diaphragm resection
- Use 39560 for diaphragm resection followed by simple repair. Use 39561 when the defect needs complex reconstruction, such as graft repair.
- 39501Diaphragm repair
- 39501 addresses repair of a diaphragm laceration. It does not describe resection followed by complex reconstruction.
- 39540Diaphragm hernia repair
- 39540 is for repair of an acute traumatic diaphragmatic hernia. Choose 39561 when diaphragm tissue is resected and the defect receives complex repair.
39561 billing questions
How does 39561 differ from 39560?
Both describe diaphragm resection. Use 39561 when the defect requires complex repair, such as graft reconstruction; 39560 is for a simple repair.
Is the repair or graft separately reported?
The complex repair of the defect created by the diaphragm resection is included in 39561. Document the reconstruction technique in the operative report.
Can modifier 50 be used when both sides are involved?
No. The descriptor and anatomy make modifier 50 inappropriate for this service.
What supports reporting 39561 rather than a diaphragm repair code?
The operative report should establish that diaphragm tissue was resected and that the resulting defect required complex reconstruction. A traumatic tear or hernia repair without this resection is a different service.
What are the global and multiple-procedure payment rules?
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 a 50% reduction.
When may an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
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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