CPT 32540 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 • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • 59 - Distinct Procedural Service |
| Complexity Level | High |
National average reimbursement for CPT 32540 by major payers:
$2,278.79
$2,214.54
$2,317.19
$2,739.65
| 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 32540 | ||||||
United | 32540 | $635.00 | 1265652267 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL | 751256948 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $450.00 | 1649463605 - PRINCETON ORTHOPAEDIC ASSOCIATES II PA | 223471829 - (NJ) PRINCETON ORTHOPAEDIC ASSOCIATES II, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $735.00 | 1659625101 - ENDOSCOPY CENTER OF GRAND JUNCTION LLC | 461251610 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $1049.00 | 1841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER | 383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $1317.00 | 1568776615 - CEDAR PARK SURGERY CENTER, LLC | 272533497 - (TX) CEDAR PARK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $250.00 | 1063470730 - ENDOSCOPY CENTER OF ARKANSAS, LLC | 201337002 - (AR) ENDOSCOPY CENTER OF ARKANSAS LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $200.00 | 1306958103 - NEI AMBULATORY SURGERY CENTER INC PC | 232429169 - (PA) NEI AMBULATORY SURGERY CENTER INC PC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $983.00 | 1386277069 - SOUTHWEST ENDOSCOPY LLC | 843623972 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $2377.00 | 1720011042 - PREMIER ORTHOPAEDIC SURGERY CENTER, LLC | 352433859 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $2785.00 | 1518359181 - ARAPAHOE SURGICENTER, LLC | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $475.00 | 1407202484 - SPORTSORTHO SURGERY CENTER LLC | 811465819 - (TX) SPORTSORTHO SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $1274.00 | 1922510643 - OPTIMUM SPINE CENTER, LLC, PEACHTREE SPINE & PAIN PHYSICIANS | 320543789 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $316.00 | 1649325713 - LIBERTY EYE SURGICAL CENTER, LIBERTY SURGICAL CENTER | 200054137 - (PA) LIBERTY EYE SURGICAL CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $450.00 | 1710420120 - AMERICAN ACCESS CARE OF MIAMI ASC LLC, AZURA SURGERY CENTER MIAMI | 814118495 - (FL) AMERICAN ACCESS CARE OF MIAMI ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32540 | $413.00 | 1982074001 - CLINICAL ASSOCIATES P A, CLINICAL ASSOCIATES, ASC | 465765243 - (MD) CLINICAL ASSOCIATES, P.A. | MD | 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 32540 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 32540 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 32540 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 |
|---|---|---|
| 32540-CPT | High | Extrapleural Enucleation Empyema Cavity |
| 32551-CPT | Moderate | Tube Thoracostomy Includes Connection To Drainagesystem (Eg Water Seal) When Performed Open (Separate Procedure) (Revised 1/1/2013) |
| 32650-CPT | Moderate | Thoracoscopy, Surgical; With Pleurodesis, Any Method |
| 32652-CPT | High | Thoracoscopy, Surgical; W Total Pulmonary Decortication Incl Pnmnlysis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 32540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 32540 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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