CPT 32097 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 32097 by major payers:
$1,038.74
$1,109.60
$1,101.21
$1,347.84
| 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 32097 | ||||||
United | 32097 | $654.00 | 1285399410 - NEAMAN SURGERY CENTER, LLC | 862826028 - (OR) NEAMAN SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $1167.00 | 1528210770 - SOUTH COUNTY OUTPATIENT ENDOSCOPY SERVICES, LP, SCOPES ENDOSCOPY CENTER | 263374547 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $445.00 | 1841952397 - SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES, LLC | 853643949 - (OK) SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $300.00 | 1548233794 - METAIRIE OPHTHALMOLOGY ASC LLC, AMBULATORY EYE SURGERY CENTER OF LOUISIANA | 621822003 - (LA) THE METAIRIE OPHTHALMOLOGY ASC, LLC DBA AMBULATORY EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $559.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $1049.00 | 1790241073 - HSS PALM BEACH AMBULATORY SURGERY CENTER, LLC | 301015589 - (FL) HSS PALM BEACH AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $635.00 | 1265652267 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL | 751256948 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $709.00 | 1023271459 - RIVERBEND AMBULATORY SURGERY CENTER LLC, DAY SURGERY AT RIVERBEND | 205575145 - (OR) RIVERBEND AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $1000.00 | 1225439250 - ADVANCED SURGERY CENTER OF SAN ANTONIO, LLC | 465742281 - (TX) ADVANCED SURGERY CENTER OF SAN ANTONIO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $2785.00 | 1245635093 - PARK RIDGE SURGERY CENTER, LLC | 464468691 - (CO) PARK RIDGE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $317.00 | 1487776365 - SEYMOUR OPERATIONS LLC, FAIR PARK SURGERY CENTER | 203173824 - (AR) SEYMOUR OPERATIONS LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $535.00 | 1588638688 - MASONICARE HEALTH CENTER | 60655131 - (CT) MASONICARE HEALTH CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $523.00 | 1528297140 - ISPM ASC AT COVINGTON, LLC | 264485600 - (GA) ISPM ASC AT COVINGTON LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $1775.00 | 1740231489 - STONEGATE SURGERY CENTER LP | 201211544 - (TX) STONEGATE SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32097 | $699.00 | 1225377278 - CENTER FOR MINIMALLY INVASIVE SURGERY PLLC, SOUNDVIEW AMBULATORY SURGERY CENTER | 911661866 - (WA) CENTER FOR MINIMALLY INVASIVE SURGERY, PLLC | WA | 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 32097 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 32097 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 32097 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 |
|---|---|---|
| 32096-CPT | High | Once Per Dos Thoracotomy, W/Diagnostic Biopsy(Ies) Of Lung Infiltrate(S) (E.G., Wedge, Incisional), Unilateral |
| 32097-CPT | High | Once Per Dos Thoracotomy W/Diagnostic Biopsy(Ies) Of Lung Nodule(S) Or Mass(Es) (E.G., Wedge, Incisional), Unilateral |
| 32100-CPT | High | Thoracotomy, Major; With Exploration And Biopsy |
| 32140-CPT | High | Thoracotomy, Major; With Cyst(S) Removal, Includes Pleural Procedure, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 32097. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 32097 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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