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2025 CPT code 32661

Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass

Code 32661 includes diagnostic thoracoscopy. Do not report separately. If other procedures are performed during the same operative session, such as a biopsy or additional resections, use appropriate add-on codes with modifier 59 if they are performed in a separate location.

Modifiers may be applicable to indicate specific circumstances such as increased procedural services (22), multiple procedures (51), or assistant surgeon (80).

Medical necessity is established by the presence of a symptomatic pericardial cyst, tumor, or mass causing significant clinical symptoms and/or posing a risk of complications such as cardiac tamponade, compression of surrounding structures, or potential for malignancy.

The physician is responsible for diagnosing the pericardial cyst, tumor, or mass, determining the appropriate surgical approach, performing the thoracoscopic excision, and managing post-operative care. This includes pre-operative evaluation, patient consent, intraoperative decision-making, and post-operative pain management and follow-up.

In simple words: A minimally invasive surgery where a small incision is made in the chest to remove a growth from the sac surrounding the heart using a camera and specialized instruments.

This procedure involves visualizing the pericardial sac with an endoscope to remove a pericardial cyst, tumor, or mass.The provider incises the chest and inserts a trocar to hold instruments and partially collapse the lung. An endoscope with a video camera is inserted to view the pericardial sac, and instruments are used to excise the cyst, tumor, or mass. A chest tube is then inserted to drain the wound and re-expand the lung.

Example 1: A 45-year-old patient presents with chest pain and shortness of breath. A CT scan reveals a pericardial cyst. The patient undergoes thoracoscopic surgery with code 32661 for excision of the cyst., A 60-year-old patient with a history of pericarditis presents with recurrent chest discomfort. Imaging studies identify a pericardial tumor. Thoracoscopic resection of the tumor is performed using code 32661., A 25-year-old patient is found to have a pericardial mass during a routine chest x-ray. After further evaluation, the decision is made to surgically remove it via thoracoscopy, using code 32661.

Documentation should include operative report detailing the thoracoscopic approach, size and location of the excised cyst, tumor, or mass, any complications, and post-operative plan. Pre-operative imaging studies (CT, MRI) confirming the diagnosis should also be included. Pathology report of the excised specimen is crucial.

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