CPT 32150 Thoracotomy Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 32150: Thoracotomy for Pleural Foreign Body or Deposit Removal

CPT code 32150 represents a thoracotomy performed to remove foreign bodies or proteinaceous deposits from the pleural membranes. This thoracic surgical code captures invasive access to the pleural space to extract material that may impair lung or pleural function. Nationally, accurate coding of this procedure affects claims processing, hospital case mix classification, and clinical quality reporting for thoracic surgery services.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 32150 is used, typical sites of service, and an outline of common modifiers associated with surgical billing. The publication also summarizes benchmarking considerations, documentation elements that underpin coding, and how this procedure is reflected in payer coverage and reimbursement frameworks.

The content is organized to help coding professionals, billing managers, and clinical leaders understand the clinical intent of 32150, the administrative implications for hospital surgical services, and areas where documentation supports accurate claim adjudication. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 32150thoracotomythoracic surgerypleural proceduressurgical codinghospital inpatientoperative reportprocedure documentation

Billing Code Overview

CPT code 32150 describes a thoracotomy performed to remove a foreign body or protein deposits from the pleural membranes lining the lungs and chest cavity. The procedure involves a surgical incision into the chest to access the pleural space and perform targeted removal of material affecting pleural surfaces.

Service type: Surgical — thoracic procedure

Typical site of service: Inpatient hospital or specialized surgical center (operating room)

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 58-year-old male presents with progressive right-sided pleuritic chest pain, low-grade fever, and dyspnea following a complicated pneumonia. Imaging (chest radiograph and CT) demonstrates a loculated pleural effusion with dense pleural-based calcified proteinaceous deposits and a suspected retained foreign body from prior penetrating trauma to the chest. After thoracentesis and antibiotic therapy fail to resolve symptoms and imaging suggests organized pleural disease, the thoracic surgery team schedules a formal open thoracotomy for removal of pleural adhesions, proteinaceous deposits (organized empyema), or retained foreign material.

The clinical workflow: preoperative evaluation by thoracic surgery and anesthesia; informed consent discussing open chest surgery risks; pre-op imaging review and labs; general endotracheal anesthesia with single-lung ventilation as indicated; open thoracotomy incision, exploration of the pleural cavity, identification and removal of foreign body or proteinaceous deposits, debridement of pleural membranes, possible pleurectomy or decortication if required; hemostasis, possible chest tube placement, and postoperative monitoring in PACU with inpatient admission for pain control, chest physiotherapy, and chest tube management until radiographic improvement and drainage criteria are met.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — default professional claim indicator	Use when submitting a standard unmodified CPT charge for the operative procedure by the billing provider.

CPT 32141: Thoracotomy for Bullectomy or Bulla Plication

CPT-32151-THORACOTOMY-FOREIGN-BODY-REMOVAL-LUNG

CPT 32151: Thoracotomy for Removal of Pulmonary Foreign Body

CPT-32036-THORACOSTOMY-EVACUATION-OF-EMPYEMA-SKIN-FLAP

CPT 32036: Thoracostomy for Evacuation of Empyema with Skin Flap

32100-THORACOTOMY-WITH

CPT 32100: Thoracotomy with Exploration

CPT-32220-TOTAL-DECORTICATION-PLEURAL-RIND-REMOVAL

CPT 32220: Total Decortication, Removal of Pleural Rind

CPT-32225-PARTIAL-DECORTICATION-PLEURAL-DEBRIDEMENT

CPT 32225: Partial Decortication to Remove Pleural Fibrous Layer

CPT-32035-THORACOSTOMY-RIB-EXCISION-EMPYEMA

CPT 32035: Thoracostomy and Rib Excision for Empyema

CPT-32097-OPEN-SURGICAL-LUNG-MASS-BIOPSY-PLEURAL-SPACE

CPT 32097: Open Surgical Biopsy of Abnormal Lung Mass

CPT-32120-THORACOTOMY-SURGICAL-RE-EXPLORATION

CPT 32120: Thoracotomy for Surgical Re-exploration

CPT-32200-OPEN-DRAINAGE-PULMONARY-ABSCESS

CPT 32200: Open Drainage of Pulmonary Abscess or Cyst

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Taxonomy Code	Specialty	Notes
207T00000X	Thoracic Surgery	Primary specialty performing open thoracotomy and pleural debridement.
2080S0120X	General Surgery	General surgeons with thoracic experience may perform thoracotomy in trauma or resource-limited settings.
2084P0800X	Critical Care Medicine	Intensivists participate in pre- and post-operative management but do not typically bill the operative CPT.
363L00000X	Anesthesiology	Anesthesiologists provide general anesthesia and airway management for thoracotomy.
207K00000X	Cardiothoracic Surgery	Cardiothoracic surgeons perform complex thoracotomies involving lung or mediastinal disease.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J86.0`	Pyothorax with fistula	Organized empyema with pleural proteinaceous deposits requiring surgical removal.
`J86.9`	Pyothorax without fistula	Empyema or pleural infection leading to loculated purulent material requiring thoracotomy for debridement.
`S27.0XXA`	Traumatic pneumothorax, initial encounter	Penetrating chest trauma may leave retained foreign bodies or cause pleural contamination necessitating thoracotomy.
`S27.1XXA`	Traumatic hemothorax, initial encounter	Hemothorax with retained clots or foreign material may require open evacuation.
`T81.89XA`	Other complications of procedures, initial encounter	Complications such as retained surgical material or post-procedural empyema may prompt thoracotomy for removal.
`J90`	Pleural effusion, not elsewhere classified	Large or loculated effusions refractory to drainage that have proteinaceous or organized components.
`T14.8`	Injury of unspecified body region	Use when a retained foreign body in the thorax is unspecified but requires operative removal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31600`	Bronchoscopy, rigid or flexible, with or without brushings, lavage, or biopsy (diagnostic)	Preoperative bronchoscopy may be performed to evaluate airway anatomy or remove endobronchial foreign bodies prior to thoracotomy.
`32505`	Thoracentesis, with insertion of indwelling catheter, pleural drainage (initial)	Often performed prior to deciding on thoracotomy for diagnostic or therapeutic drainage of pleural effusion.
`32480`	Decortication, pulmonary, via thoracotomy (pleural decortication)	Performed when organized empyema or thickened pleura requires removal of fibrous peel; may be billed in conjunction or instead of simple removal of deposits.
`32551`	Thoracoscopy, diagnostic; with or without obtaining washings, biopsy	Minimally invasive thoracoscopic evaluation may be attempted before open thoracotomy; conversion to `32150` occurs if open removal is required.
`32554`	Thoracoscopy with removal of foreign body from pleural space	Video-assisted or thoracoscopic removal; if converted to open, `32150` describes the open approach.
`76000`	Fluoroscopy (diagnostic)	Intraoperative imaging support for localization of foreign bodies may be used adjunctively during thoracotomy.

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