CPT 32096 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Respiratory System |
| Common Place of Service | • 21 - Inpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 32096 |
National average reimbursement for CPT 32096 by major payers:
$1,115.38
$1,109.19
$1,105.31
$1,346.42
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 32096 | ||||||
United | 32096 | $1049.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $200.00 | 1659731669 - PHOENIX ASC, LP, CARDIAC SURGERY CENTER OF PHOENIX | 474334606 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $827.00 | 1093779951 - EYE SURGERY AND LASER CLINIC, INC. | 562172461 - (NC) EYE SURGERY AND LASER CLINIC INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $300.00 | 1104072453 - MACON OUTPATIENT SURGERY INC | 203027560 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $283.00 | 1346878303 - HOT SPRINGS AMBULATORY SURGERY CENTER, LLC | 832533389 - (AR) HOT SPRINGS AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $448.00 | 1063495257 - DOCTORS SURGICAL PARTNERSHIP LLC, MELBOURNE SAME DAY SURGERY | 593490279 - (FL) DOCTORS SURGICAL PARTNERSHIP LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $525.00 | 1144382284 - PASADENA SURGERY CENTER LLC, PASADENA SURGERY CENTER | 203571435 - (FL) PASADENA SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $991.00 | 1154318103 - OPTUM CARE WASHINGTON PLLC, OPTUM - KEMP SURGERY CENTER | 910214500 - THE EVERETT CLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $1274.00 | 1851433718 - TEXAN AMBULATORY SURGERY CENTER, TEXAN SURGERY CENTER | 331058382 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $703.00 | 1578221479 - SKIN CANCER AND LASER SURGERY CENTER LLC | 854119523 - (IN) SKIN CANCER AND LASER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $1124.00 | 1003332883 - DESERT VISTA SURGICAL CENTER LLC | 821195281 - (AZ) DESERT VISTA SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $2517.00 | 1235146325 - WEBSTER AMBULATORY SURGERY CENTER LP, WEBSTER SURGERY CENTER | 205953387 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $1000.00 | 1609376409 - KOKOMO AMBULATORY SURGERY CENTER | 823461246 - (IN) KOKOMO AMBULATORY SURGERY CENTER | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $339.00 | 1144216847 - RIVER PARK ASC LLC | 721510504 - (LA) RIVER PARK ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $2302.00 | 1336790237 - AURORA ENDOSCOPY SURGICENTER, LLC | 825396997 - (CO) AURORA ENDOSCOPY SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 32096 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 32096 code is part of the Surgery services used for Surgical Procedures on the Respiratory System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 32096 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 32035-CPT | High | Thoracostomy;Rib Resec For Empyema |
| 32036-CPT | High | Thoracostomy W Open Flap Drainage For Em |
| 32096-CPT | High | Once Per Dos Thoracotomy, W/Diagnostic Biopsy(Ies) Of Lung Infiltrate(S) (E.G., Wedge, Incisional), Unilateral |
| 32100-CPT | High | Thoracotomy, Major; With Exploration And Biopsy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 32096. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 32096 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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