CPT 32940 Surgical Pleurolysis Reimbursement | OpenPayer

Summary & Overview

CPT 32940: Surgical Pleurolysis (Lysis of Pleural Adhesions)

CPT code 32940 identifies a surgical pleurolysis procedure in which the chest cavity is opened and an adherent lung is released from surrounding chest wall tissues. Nationally, this code matters because it captures interventions used to restore pulmonary expansion in patients with pleural adhesions from prior infection, inflammation, or surgery. Proper coding affects procedure tracking, clinical reporting, and facility reimbursement for thoracic surgical services.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and the most relevant billing modifiers that accompany operative thoracic codes. The publication also summarizes benchmark considerations and common coding scenarios to clarify when CPT code 32940 is typically reported.

This brief provides practical reference information about the code’s clinical intent, where the service is commonly delivered, and the payer landscape relevant to national billing and reporting. Data not available in the input are explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 32940pleurolysisthoracic surgerylung adhesion releasesurgical procedureoperative codinghospital servicesprocedure coding

Billing Code Overview

CPT code 32940 describes a surgical procedure in which the provider incises the chest cavity and releases an adherent lung from the surrounding chest wall tissues. This procedure is a form of pleural/pleurolysis intervention intended to free the lung from restrictive adhesions that limit expansion.

Service type: Surgical pleurolysis / lysis of pleural adhesions
Typical site of service: Hospital inpatient or outpatient surgical setting, operating room or procedure suite

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 55–70-year-old adult presenting with chronic pleural disease or post-surgical pleural adhesions causing trapped lung, recurrent pleural effusions, or persistent atelectasis with respiratory compromise. The patient often has a history of prior thoracic surgery, pleurodesis, empyema, trauma, or prolonged inflammation leading to dense pleural adhesions. Preoperative evaluation includes chest imaging (chest X-ray and CT), pulmonary function testing as indicated, and review of prior operative reports. The procedure 32940 (decortication — surgical incision of the chest wall and release of adherent lung from the chest wall) is performed in an operating room under general anesthesia with single-lung ventilation when feasible. Intraoperative workflow includes thoracotomy or thoracoscopic access, careful mobilization and dissection of pleural peel and adhesions to allow lung re-expansion, hemostasis, chest tube placement, and closure. Postoperative care includes chest tube management, monitoring for air leak or re-expansion pulmonary edema, pain control, respiratory therapy, and follow-up imaging to document lung re-expansion and resolution of effusion or infection.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typically required (extensive adhesiolysis, prolonged operative time beyond usual complexity).

CPT 32960: Therapeutic Induction of Partial Pneumothorax

CPT-32905-THORACIC-REPAIR-FOR-EMPYEMA

CPT 32905: Thoracic Repair of Chest Cavity for Empyema

CPT-32906-RIB-EXCISION-CHEST-WALL-COLLAPSE-BRONCHOPLEURAL-FISTULA-CLOSURE

CPT 32906: Rib Excision with Chest Wall Collapse and Bronchopleural Fistula Closure

CPT-32900-RIB-RESECTION-SURGICAL-PROCEDURE

CPT 32900: Rib Resection, Partial or Complete

Taxonomy Code	Specialty	Notes
`338N00000X`	Thoracic Surgery	Primary specialty performing decortication and complex pleural surgery.
`2086S0121X`	General Surgery	General surgeons with thoracic training may perform this procedure in some centers.
`207RP0501X`	Pulmonary Disease (Interventional Pulmonology)	May be involved in evaluation and in some minimally invasive pleural procedures; less commonly performs open decortication.
`2084P0800X`	Critical Care Medicine	Often involved in perioperative management of high-risk patients undergoing decortication.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J86.9`	Pyothorax without fistula, unspecified	Empyema with pleural peel often requires decortication to evacuate infected material and free the lung.
`J90`	Pleural effusion, not elsewhere classified	Recurrent or loculated effusions with trapped lung may necessitate surgical decortication for lung re-expansion.
`J94.8`	Other pleural conditions	Includes pleural thickening and other conditions causing restrictive pleural disease addressed by decortication.
`S27.2`	Traumatic pneumothorax without open wound into cavity	Post-traumatic pleural adhesions and trapped lung after chest trauma may require decortication.
`B96.89`	Other specified bacterial agents as the cause of diseases classified elsewhere	Causative organisms for empyema that lead to chronic pleural space disease requiring surgical intervention.
`C80.1`	Malignant (primary) pleural effusion	Malignant pleural disease with dense adhesions or trapped lung sometimes necessitates decortication for symptom relief.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32551`	Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed	Frequently performed preoperatively or postoperatively for pleural drainage and chest tube placement after decortication.
`32557`	Thoracotomy, with decortication, pulmonary; wedge resection, single lobe — (Note: `32940` is specific code for decortication in some code sets; include `32557` as related thoracic access/resection when concurrent lung resection is needed)	May be performed during the same operative session if nonviable lung tissue or focal disease requires limited resection.
`32663`	Thoracoscopy, surgical; with decortication of lung (including pleurectomy when performed)	Minimally invasive alternative or adjunct for decortication; used when procedure is performed thoracoscopically rather than open.
`36415`	Collection of venous blood by venipuncture	Common preoperative laboratory draw required for preoperative assessment and monitoring.
`94002`	Ventilation assist and management initiation of pressure or volume preset ventilators for assisted ventilation for acute respiratory failure	May be billed in postoperative critical care settings when mechanical ventilation is initiated (note: billing depends on payer rules).

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