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See a sample rate comparisonCPT 32604 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Biopsy Of Chest Interior, An Exam Of The Interior Of The Chest Using A Scope (Thoracoscopy). The Procedure Takes A Small Sample Of Tissue For Testing (Biopsy) From The Lungs The Protective Sac Around The Heart Or The Lining Of The Chest.
| 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 | AS - PA/NP/CNS assistant at surgery LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $445.90 national non-facility rate (2026) · View Medicare rates for 32604 |
| Medicaid Fee Schedule | $347.09 median of the 8 states in the free preview · View Medicaid rates for 32604 |
National average reimbursement for CPT 32604 by major payers:
$590.07
$649.60
$664.32
$772.42
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CPT 32604
5 of 25 sample ratesHigher to lower in this preview
Grove City Medical Center
$28,621.23Published rateMinimally Invasive Surgicenter LLC
Minimally Invasive Surgicenter L
$5,020.00Published rateRocky Mountain Surgery Center LLC
Rocky Mountain Surgery Center, LLC
$2,781.00Published rateLagreca Eye Clinic PC, The Eye Clinic Surgicenter Lagreca Eye Clinic
Lagreca Eye Clinic, PC
$2,090.00Published rateSummit Endoscopy Center
$500.00Published rate
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See a sample payer proposalCPT 32604 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 32604 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 32604 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 |
|---|---|---|
| 32601-CPT | Moderate | Scope Exam Of Chest Interior, An Exam Of The Interior Of The Chest Using A Scope (Thoracoscopy). The Exam May Include The Lungs Or The Protective Sac Around The Heart. |
| 32604-CPT | Moderate | Biopsy Of Chest Interior, An Exam Of The Interior Of The Chest Using A Scope (Thoracoscopy). The Procedure Takes A Small Sample Of Tissue For Testing (Biopsy) From The Lungs The Protective Sac Around The Heart Or The Lining Of The Chest. |
| 32606-CPT | Moderate | Biopsy Of Chest Interior, An Exam Of The Interior Of The Chest Using A Scope (Thoracoscopy). The Procedure Takes A Small Sample Of Tissue For Testing (Biopsy) From The Lungs The Protective Sac Around The Heart Or The Lining Of The Chest. |
| 32608-CPT | Moderate | Lung Biopsy With Scope, Surgery Aided By A Scope (Thoracoscope) To Remove A Sample Of Tissue From A Lung For Testing (Biopsy). The Procedure May Remove Tissue From The Lung Itself Or From The Protective Sac Around The Lung (Pleura). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 32604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 32604 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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