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 |
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 | $2302.00 | 1336790237 - AURORA ENDOSCOPY SURGICENTER, LLC | 825396997 - (CO) AURORA ENDOSCOPY SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $6068.00 | 1851650428 - TEXAS HEALTH OUTPATIENT SURGERY CENTER ALLIANCE | 822296081 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $1374.00 | 1528553559 - SURGICAL PAIN CENTER OF THE ADIRONDACKS, LLC | 821943675 - (NY) SURGICAL PAIN CENTER OF THE ADIRONDACKS LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $350.00 | 1316946106 - CHARLESTON ENDOSCOPY CENTER | 571104687 - (SC) CHARLESTON ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $5213.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $1723.00 | 1861766016 - HAYS SURGERY CENTER, LLC | 274579547 - (TX) HAYS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $802.00 | 1720041536 - CENTER FOR AMBULATORY SURGERY LLC | 161553086 - (NY) CENTER FOR AMBULATORY SURGERY, L.L.C. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $461.00 | 1588797807 - SPOKANE DIGESTIVE DISEASE CENTER, P.S., SOUTH ASC | 911013238 - (WA) SPOKANE DIGESTIVE DISEASE CENTER P.S. | WA | 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 | $2828.00 | 1740251909 - NORTH FLORIDA GI CENTER LTD, HCA FLORIDA NORTH FLORIDA ENDOSCOPY CENTER | 621727350 - (FL) NORTH FLORIDA GI CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $525.00 | 1073570552 - PHYSICIANS SURGICAL CENTER LLC, PHYSICIANS SURGICAL CENTER, AN AFFILIATE OF HEALTHSOUTH | 731452371 - (OK) PHYSICIANS SURGICAL CENETER, L.L.C. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $624.00 | 1831366517 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $1049.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32096 | $418.00 | 1285944504 - NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK, LLC | 272840356 - (MD) NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK LLC | MD | 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 | 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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