CPT 32609 Fee Schedule
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.
| 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 32609 |
National average reimbursement for CPT 32609 by major payers:
$353.19
$358.02
$362.60
$440.84
| 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 32609 | ||||||
United | 32609 | $3694.00 | 1033351119 - SSM ST CLARE SURGICAL CENTER LLC, SSM ST CLARE SURGICAL CENTER | 261439695 - (MO) SSM ST CLARE SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $3365.00 | 1871912485 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, SOUTH DENVER ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $2500.00 | 1861702359 - INLAND OUTPATIENT SURGERY CENTER, INC. | 900621582 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $945.00 | 1487627642 - SURGERY CENTER OF CORAL GABLES LLC, SURGERY CENTER OF CORAL GABLES LLC | 621827649 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $5249.00 | 1316947609 - AMARILLO ENDOSCOPY CENTER, LP | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $1538.00 | 1992701049 - NORTHWEST FLORIDA SURGERY CENTER | 593123289 - (FL) NORTHWEST FLORIDA SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $2653.00 | 1174005235 - IDAHO FALLS ASC | 823089090 - (ID) IDAHO FALLS ASC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $2900.00 | 1669483137 - PHYSICIANS AMBULATORY SURGERY CENTER INC | 593216499 - (FL) PHYSICIANS AMBULATORY SURGERY CENTER, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $5020.00 | 1487716650 - CARONDELET ST. MARY'S NORTHWEST, LLC, CARONDELET FOOTHILLS SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $3661.00 | 1902472715 - CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE INC, CARTI SURGERY CENTER | 710437657 - (AR) CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE INC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $5249.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $2040.00 | 1770042111 - O'FALLON SURGICAL CENTER, LLC, PHYSICIANS SURGICAL CENTER | 814388166 - (IL) OFALLON SURGICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $8055.00 | 1346403854 - THE EMORY CLINIC INC, EMORY ORTHOPAEDIC SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $5354.00 | 1861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK | 832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 32609 | $1668.00 | 1750696134 - RMA OF PHILADELPHIA SURGICAL CENTER LLC | 273096545 - (PA) RMA OF PHILADELPHIA SURGICAL CENTER LLC | PA | 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 32609 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 32609 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 32609 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 | Thoracoscopy, Diagnostic (Separate Procedure); Lungs, Pericardial Sac, Mediastinal Or Pleural Space, Without Biopsy |
| 32607-CPT | Moderate | Once Per Dos Thoracoscopy; W/Diagnostic Biopsy(Ies) Of Lung Infiltrate(S) (E.G., Wedge, Incisional) Unilateral |
| 32608-CPT | Moderate | Once Per Dos Thoracoscopy; W/Diagnostic Biopsy(Ies) Of Lung Nodule(S) Or Mass(Es) (E.G., Wedge, Incisional), Unilateral |
| 32609-CPT | Moderate | Once Per Dos Thoracoscopy; W/Biopsy(Ies) Of Pleura |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 32609. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 32609 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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