2025 CPT code 32666
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Respiratory System Surgery Feed
Surgical thoracoscopy with therapeutic wedge resection of lung mass or nodule, initial unilateral.
Modifiers 50 (bilateral procedure), 59 (distinct procedural service), and possibly others depending on the specific circumstances of the procedure.
Medical necessity for a therapeutic wedge resection is established by the presence of a clinically significant lung mass or nodule requiring surgical removal for diagnostic or therapeutic reasons (e.g., suspected malignancy, symptomatic lesion). The procedure must be medically appropriate and not performed for cosmetic reasons.
Thoracic surgeon.Responsibilities include pre-operative assessment, surgical planning, performing the thoracoscopic procedure, managing intraoperative complications, and post-operative care.
In simple words: This surgery uses a small camera and instruments inserted through small incisions in the chest to remove a piece of lung with a tumor or nodule.The surgeon makes a small cut, inserts a tube to help see the lung, then removes the abnormal part and closes the incision. A chest tube is placed to help drain fluid.
This procedure involves visualizing the chest cavity and lung to resect (remove) a section of lung containing a mass or nodule.The provider incises the chest, inserts a trocar (port) holding instruments, and passes air to partially collapse the lung for visualization. A flexible or rigid endoscope with a video camera is inserted to view the chest cavity, and other instruments are used through additional trocars to clamp and cut bronchial tubes and blood vessels connected to the wedge-shaped section of lung to be removed. The lung section is excised, and the area is sutured. Trocars and the endoscope are removed, and a chest tube is inserted to drain and re-expand the lung.For bilateral procedures, report 32666 with modifier 50. Do not report 32666 with 32440, 32442, 32445, 32488, or 32671.
Example 1: A 65-year-old male patient presents with a suspicious lung nodule detected on a CT scan.A thoracoscopic wedge resection (32666) is performed to remove the nodule for biopsy and definitive diagnosis. Pathology confirms malignancy, and further surgical intervention may be necessary. , A 70-year-old female patient is diagnosed with lung cancer, and a VATS wedge resection (32666) is performed to remove a peripheral lung tumor. Post-operative imaging shows complete resection., A 58-year-old male presents with multiple small lung nodules.A VATS procedure is performed, removing one nodule with a wedge resection (32666) while additional nodules are biopsied. Pathology confirms that the wedge resection was sufficient for the single nodule.Other biopsies reveal benign findings.
Pre-operative imaging (CT scan, X-ray), operative report detailing the procedure, pathology report confirming the nature of the resected tissue, post-operative imaging (chest X-ray), and any relevant notes regarding patient recovery.
** Code 32666 is for the initial unilateral therapeutic wedge resection.Additional resections on the same side are reported using code 32667.The choice between 32666 and other wedge resection codes depends on the extent of resection and whether intraoperative pathology consultation influences the extent of the surgery.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Thoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center