CPT 32100 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 • 23 - Emergency Room |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 32100 |
National average reimbursement for CPT 32100 by major payers:
$1,097.04
$1,134.60
$1,200.22
$1,371.61
| 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 32100 | ||||||
United | 32100 | $1955.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $630.00 | 1740629245 - SURGERY AFFILIATES, LLC, PINNACLE SURGERY CENTER | 453011327 - (CO) SURGERY AFFILIATES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $567.00 | 1003855594 - OHIO EYE ASSOCIATES, INC., OHIO EYE ASSOCIATES EYE SURGERY & LASER CENTER | 341171920 - (OH) OHIO EYE ASSOCIATES, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $677.00 | 1720268279 - PEARL ROAD SURGERY CENTER, LLC | 260812886 - (OH) PEARL ROAD SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $425.00 | 1518379205 - IPS ASC, LLC, GEMINI SURGERY CENTER | 465227049 - (OH) IPS ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $130.00 | 1639203888 - VALLEY MEDICAL GROUP, P.C., VALLEY MEDICAL GROUP AMBULATORY SURGERY & PROCEDURES CENTER | 42945394 - (MA) VALLEY MEDICAL GROUP, P.C. | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $1955.00 | 1780683490 - METROCREST SURGERY CENTER LP, BAYLOR SURGICARE AT CARROLLTON | 30380493 - (TX) METROCREST SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $1049.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $923.00 | 1205845740 - THE UROLOGY CENTER LLC | 311579733 - (OH) THE UROLOGY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $1192.00 | 1235551052 - LONG ISLAND DIGESTIVE ENDOSCOPY CENTER, LLC | 454714972 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $814.00 | 1750036174 - GLACIER SURGICAL INC. | 861271667 | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $253.00 | 1306486634 - FREDERICKSBURG ENDOSCOPY CENTER, LLC | 834398314 - (VA) FREDERICKSBURG ENDOSCOPY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $1687.00 | 1447608088 - IRVINE ENDOSCOPY PARTNERS LLC | 812267690 - (CA) IRVINE ENDOSCOPY PARTNERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $983.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32100 | $835.00 | 1558327338 - DANBURY SURGICAL CENTER LP, SURGICAL CENTER OF RIDGEFIELD | 631263704 - (CT) DANBURY SURGICAL CENTER LP | CT | 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 32100 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 32100 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 32100 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 32100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 32100 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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