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CPT code 38500: Lymph node biopsy, open, superficial node2026 Medicare rate & RVUs in Manhattan, NY

Open biopsy or excision of a superficial lymph node is reported when tissue sampling or removal requires direct surgical exposure.

CMS RVU26DEffective Oct 1, 2026One payment locality5K Medicare services in 2024

In Manhattan, NY, Medicare pays $429.89 for 38500 in the office and $285.90 when it’s performed in a hospital or facility.

$429.89Office (non-facility)
$285.90Hospital or facility
+16.4%vs the national office rate ($369.41)

Check a contract rate as a % of Medicare · 38500 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 38500 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Manhattan, NY
  2. What 38500 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 38500 covers

Code 38500 describes open sampling or removal of one or more superficial lymph nodes through a surgical incision. The surgeon exposes the node directly and removes all or part of it for pathologic evaluation. It is used when an accessible superficial node needs tissue diagnosis or excision, rather than needle sampling or removal from a deep nodal basin. Surgeons commonly perform this service in hospital outpatient departments and ambulatory surgery settings; office performance is also represented in Medicare claims.

Select the code based on the open approach and superficial location, not solely on the diagnosis or pathology result. The operative report should identify the site, approach, and whether the node was sampled or removed, and the record should support the clinical reason for obtaining tissue. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS payment is 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Manhattan, NY compares for 38500

Across 109 of 109 payment localities, the office rate for 38500 runs from $324.41 in Arkansas to $464.43 in San Benito County, CA. Manhattan, NY pays $429.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

38500 in Manhattan, NY vs other payment areas
  1. Manhattan, NY · this page$429.89
  2. NYC suburbs and Long Island, NY · New York$443.87+$13.98
  3. Poughkeepsie and northern NYC suburbs, NY · New York$401.79−$28.10
  4. Queens, NY · New York$429.88−$0.01
  5. Rest of New York · New York$349.70−$80.19
  6. Los Angeles, CA · California$403.87−$26.02
  7. Washington, DC area · District of Columbia$417.89−$12.00

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

38500 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$424.22$295.23
Chicago, ILIllinois$410.29$285.75
AlaskaAlaska$431.73$299.76
AlabamaAlabama$329.40$220.97
ArkansasArkansas$324.41$217.97
ArizonaArizona$358.40$238.32
Bakersfield, CACalifornia$380.72$244.91
Chico, CACalifornia$378.28$242.47

38500 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$324.41

$431.73

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
38500 office rate range by state
State / territoryOffice rate rangeLocalities
AK$431.731
AL$329.401
AR$324.411
AZ$358.401
CA$378.28–$464.4329
CO$378.121
CT$394.811
DC$417.891
DE$364.411
FL$375.04–$424.223
GA$351.88–$379.282
GU$386.321
HI$386.321
IA$332.951
ID$336.311
IL$367.57–$410.294
IN$338.211
KS$333.791
KY$342.911
LA$343.34–$360.772
MA$376.72–$413.032
MD$370.77–$417.893
ME$340.79–$356.382
MI$354.52–$382.482
MN$354.511
MO$338.86–$359.123
MS$331.581
MT$369.351
NC$344.111
ND$351.561
NE$334.101
NH$374.501
NJ$397.12–$413.772
NM$357.551
NV$364.611
NY$349.70–$443.875
OH$350.881
OK$339.621
OR$359.62–$387.652
PA$350.07–$386.292
PR$371.341
RI$375.641
SC$348.511
SD$349.451
TN$335.861
TX$347.86–$380.208
UT$353.401
VA$356.91–$417.892
VI$371.341
VT$352.411
WA$375.27–$419.072
WI$339.551
WV$354.101
WY$361.601

See 38500 in every payment locality

How the 38500 rate is calculated

Each of 38500’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 38500

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.70

3.70 RVUs× 1.000 GPCI

Practice expense6.46

6.46 RVUs× 1.000 GPCI

Malpractice0.90

0.90 RVUs× 1.000 GPCI

Adjusted RVUs

11.0600

Conversion factor

$33.4009

Medicare rate

$369.41

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Manhattan, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,741

Code
38500
Physician work
3.70
Practice expense
6.46
Malpractice
0.90

GPCI2026.csv

78

Locality
Manhattan, NY
Physician work
1.064
Practice expense
1.162
Malpractice
1.586
Office calculation for 38500 in Manhattan, NY
ComponentRVULocality factorAdjusted
Physician work3.70× 1.0643.9368
Practice expense6.46× 1.1627.5065
Malpractice0.90× 1.5861.4274
Total RVUs12.8707
Conversion factor× 33.4009

Office rate, Manhattan, NY$429.89

Office: (3.7 × 1.064 + 6.46 × 1.162 + 0.9 × 1.586) × $33.4009 = $429.89

Facility: (3.7 × 1.064 + 2.75 × 1.162 + 0.9 × 1.586) × $33.4009 = $285.90

Open 38500 in the RVU calculator

Payment rules and modifiers for 38500

38500 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38500

Lymph node biopsy, open, superficial node

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 38500

Lymph node biopsy, open, superficial node

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

38500 without 50 · national office

$369.41

Lymph node biopsy, open, superficial node

38500-50 · Bilateral: 150%

$554.12

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 38500

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 38500
CodeHow it relatesOffice range, Manhattan, NY
Used instead
38505Lymph node biopsy, needle, superficial nodeNeedle biopsy is used instead when tissue is obtained percutaneously rather than through open exposure.$195.27
Same family
38510Lymph node biopsy, open, deep cervicalOpen biopsy or excision for deep cervical lymph nodes.$636.88
38525Axillary node biopsy, open, deep axillary nodesOpen biopsy or excision for deep axillary lymph nodes.No office rate
38530Lymph node biopsy, internal mammary nodesOpen biopsy or excision for internal mammary lymph nodes.No office rate
38531Groin node surgery, open inguinofemoral nodesOpen biopsy or excision for inguinofemoral lymph nodes.No office rate

How 38500 has changed in Manhattan, NY

38500 · Office / nonfacility

$429.89

Effective 2026-10-01

The base rate is $46.64 higher than on 2025-10-01, moving from $383.25 to $429.89 (12.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $383.25changed to$429.89

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.79 changed to 3.70
    • Practice expense RVU 5.45 changed to 6.46
    • Malpractice RVU 0.88 changed to 0.90
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.166 changed to 1.162
    • Malpractice GPCI 1.656 changed to 1.586

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $395.89changed to$383.25

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.46 changed to 5.45
    • Malpractice RVU 0.90 changed to 0.88

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $389.43changed to$395.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $410.92changed to$389.43

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.89 changed to 0.90
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.184 changed to 1.166
    • Malpractice GPCI 1.843 changed to 1.656

  5. January 1, 2023

    RVU23A

    $427.95changed to$410.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.45 changed to 5.46
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.203 changed to 1.184
    • Malpractice GPCI 2.031 changed to 1.843

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $427.27changed to$427.95

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.40 changed to 5.45
    • Malpractice RVU 0.86 changed to 0.89

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $417.13changed to$427.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.03 changed to 5.40
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.192 changed to 1.203
    • Malpractice GPCI 1.823 changed to 2.031

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $403.56changed to$417.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.92 changed to 5.03
    • Malpractice RVU 0.87 changed to 0.86
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.180 changed to 1.192
    • Malpractice GPCI 1.615 changed to 1.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $400.14changed to$403.56

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.85 changed to 4.92

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $399.36changed to$400.14

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.83 changed to 4.85
    • Practice expense GPCI 1.174 changed to 1.180
    • Malpractice GPCI 1.690 changed to 1.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $401.16changed to$399.36

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.85 changed to 4.83
    • Malpractice RVU 0.88 changed to 0.87
    • Practice expense GPCI 1.168 changed to 1.174
    • Malpractice GPCI 1.764 changed to 1.690

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $400.92changed to$401.16

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.84 changed to 4.85
    • Malpractice RVU 0.86 changed to 0.88

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $398.92changed to$400.92

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $385.86changed to$398.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.83 changed to 4.84
    • Malpractice RVU 0.75 changed to 0.86
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.165 changed to 1.168
    • Malpractice GPCI 1.518 changed to 1.764

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $385.35changed to$385.86

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.43 changed to 4.83
    • Malpractice RVU 0.78 changed to 0.75
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.162 changed to 1.165
    • Malpractice GPCI 1.271 changed to 1.518

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $385.35

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$429.89$285.90RVU26D
2026-07-01$429.89$285.90RVU26C
2026-04-01$429.89$285.90RVU26B
2026-01-01$429.89$285.90RVU26A
2025-10-01$383.25$293.11RVU25D
2025-07-01$383.25$293.11RVU25C
2025-04-01$383.25$293.11RVU25B
2025-01-01$383.25$293.11RVU25A
2024-10-01$395.89$300.80RVU24D
2024-07-01$395.89$300.80RVU24C
2024-04-01$395.89$300.80RVU24B
2024-03-09$395.89$300.80RVU24AR
2024-01-01$389.43$295.89RVU24A
2023-10-01$410.92$311.01RVU23D
2023-07-01$410.92$311.01RVU23C
2023-04-01$410.92$311.01RVU23B
2023-01-01$410.92$311.01RVU23A
2022-10-01$427.95$323.04RVU22D
2022-07-01$427.95$323.04RVU22C
2022-04-01$427.95$323.04RVU22B
2022-01-01$427.95$323.04RVU22A
2021-10-01$427.27$321.49RVU21D
2021-07-01$427.27$321.49RVU21C
2021-04-01$427.27$321.49RVU21B
2021-01-01$427.27$321.49RVU21A
2020-10-01$417.13$318.19RVU20D
2020-07-01$417.13$318.19RVU20C
2020-04-01$417.13$318.19RVU20B
2020-01-01$417.13$318.19RVU20A
2019-10-01$403.56$309.15RVU19D
2019-07-01$403.56$309.15RVU19C
2019-04-01$403.56$309.15RVU19B
2019-01-01$403.56$309.15RVU19A
2018-10-01$400.14$307.96RVU18D
2018-07-01$400.14$307.96RVU18C
2018-04-01$400.14$307.96RVU18B
2018-01-01$400.14$307.96RVU18AR1
2017-10-01$399.36$308.78RVU17D
2017-07-01$399.36$308.78RVU17C
2017-04-01$399.36$308.78RVU17B
2017-01-01$399.36$308.78RVU17A
2016-10-01$401.16$310.41RVU16D
2016-07-01$401.16$310.41RVU16C
2016-04-01$401.16$310.41RVU16B
2016-01-01$401.16$310.41RVU16A
2015-10-01$400.92$310.68RVU15D
2015-07-01$400.92$310.68RVU15C
2015-04-01$398.92$309.14RVU15B
2015-01-01$398.92$309.14RVU15A
2014-10-01$385.86$296.14RVU14D
2014-07-01$385.86$296.14RVU14C
2014-04-01$385.86$296.14RVU14B
2014-01-01$385.86$296.14RVU14A
2013-10-01$385.35$288.88RVU13D
2013-07-01$385.35$288.88RVU13C
2013-04-01$385.35$288.88RVU13B
2013-01-01$385.35$288.88RVU13AR

Price 38500 for an earlier date of service

Where the Manhattan, NY rate applies

Manhattan, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

38500 billing questions

When should 38500 be used instead of 38505?

Use 38500 when the surgeon obtains the superficial node through an open incision. Code 38505 is for needle biopsy of a lymph node.

How does the location affect code selection?

Code 38500 is for superficial nodes. Deep cervical, deep axillary, internal mammary, and inguinofemoral node procedures have distinct codes, including 38510, 38525, 38530, and 38531.

What postoperative care is included?

Related postoperative visits during the 10-day global period are included in the procedure.

How is bilateral 38500 paid?

When reported bilaterally with modifier 50, CMS pays 150%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 38500PPRRVU2026_Oct_nonQPP.csv, line 4,741 (RVU26D)
Geographic factors for Manhattan, NYGPCI2026.csv, line 78 (RVU26D)

Open CMS sourceHow we calculate rates

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