CPT® Code 32651

Thoracoscopy, surgical; with partial pulmonary decortication (CPT® Code 32651) is a minimally invasive surgical procedure that involves the removal of a thickened fibrin layer, known as the rind or peel, from the outer surface of part of the lung. This procedure is typically performed using video-assisted thoracoscopic surgery (VATS), which allows for enhanced visualization and precision during the operation. The approach begins with a small incision made between the ribs, usually at the fifth or sixth intercostal space, just below the tip of the scapula. This incision provides access to the pleural space, where the pleura is identified and a thoracoscope is introduced. The thoracoscope is a specialized instrument that enables the surgeon to visualize the internal structures of the thoracic cavity. During the procedure, any fluid present in the pleural space is aspirated, and the area is thoroughly explored. Additional incisions are made to allow for the introduction of surgical instruments necessary for the decortication process. The surgeon carefully dissects the thickened fibrin layer from the underlying visceral pleura, ensuring that all affected portions of the lung are addressed. This procedure is indicated for patients with conditions that lead to the formation of fibrous tissue around the lung, which can restrict lung expansion and impair respiratory function.