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

In Puerto Rico, Medicare pays $371.34 for 38500 in the office and $246.06 when it’s performed in a hospital or facility.

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.

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 Puerto Rico 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. Puerto Rico pays $371.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

38500 rates by state

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

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.

Payment rules and modifiers for 38500

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

What modifiers do to the payment

When to use modifier 50

Codes related to 38500

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

How 38500 has changed in Puerto Rico

Price 38500 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates