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CPT code 38505: Lymph node biopsy, needle, superficial node2026 Medicare rate & RVUs in Puerto Rico

Percutaneous needle sampling of a superficial lymph node for tissue diagnosis, commonly used to evaluate palpable or imaging-detected cervical, axillary, or inguinal adenopathy.

CMS RVU26DEffective Oct 1, 2026One payment locality36.6K Medicare services in 2024

In Puerto Rico, Medicare pays $171.50 for 38505 in the office and $74.92 when it’s performed in a hospital or facility.

$171.50Office (non-facility)
$74.92Hospital or facility
+0.7%vs the national office rate ($170.34)

Check a contract rate as a % of Medicare · 38505 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 38505 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 38505 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 38505 covers

Code 38505 describes needle sampling of a superficial lymph node to obtain tissue for diagnostic evaluation. It is commonly performed for enlarged or suspicious cervical, axillary, or inguinal nodes, including nodes identified on examination or imaging. Radiologists, surgeons, and other qualified physicians may perform the procedure in an office, imaging department, or facility setting. The needle technique distinguishes this service from open removal or biopsy of a node.

Report the code when the documented procedure involves needle biopsy of a superficial node; record the sampled site and the technique used. Same-day preoperative and postoperative care is included in its 0-day global period. 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 service, modifier 50 results in payment at 150%. Medicare does not pay an assistant at surgery for this code, and 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 38505

Across 109 of 109 payment localities, the office rate for 38505 runs from $151.67 in Arkansas to $223.30 in San Benito County, CA. Puerto Rico pays $171.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

38505 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$171.50
  2. Los Angeles, CA · California$191.22+$19.72
  3. Washington, DC area · District of Columbia$193.88+$22.38
  4. Miami, FL · Florida$183.66+$12.16
  5. Chicago, IL · Illinois$178.62+$7.12
  6. Manhattan, NY · New York$195.27+$23.77
  7. Alaska · Alaska$201.02+$29.52

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

38505 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$153.77$70.18
ArkansasArkansas$151.67$69.62
ArizonaArizona$166.03$73.46
Bakersfield, CACalifornia$179.95$75.25
Chico, CACalifornia$179.43$74.73
El Centro, CACalifornia$179.46$74.76
Fresno, CACalifornia$179.43$74.73
Hanford, CACalifornia$179.43$74.73

38505 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.

$151.67

$201.37

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

View every state and territory as a table
38505 office rate range by state
State / territoryOffice rate rangeLocalities
AK$201.021
AL$153.771
AR$151.671
AZ$166.031
CA$179.43–$223.3029
CO$176.951
CT$181.271
DC$193.881
DE$168.681
FL$168.23–$183.663
GA$159.24–$173.452
GU$183.421
HI$183.421
IA$157.321
ID$158.321
IL$163.72–$178.624
IN$159.181
KS$156.691
KY$157.331
LA$157.12–$164.462
MA$176.00–$193.742
MD$171.75–$193.883
ME$159.17–$167.232
MI$161.26–$170.292
MN$169.621
MO$154.62–$164.943
MS$153.171
MT$170.331
NC$160.731
ND$166.971
NE$158.121
NH$174.261
NJ$183.35–$192.062
NM$162.121
NV$169.511
NY$163.01–$199.865
OH$160.571
OK$157.001
OR$168.21–$182.252
PA$160.77–$177.002
PR$171.501
RI$174.441
SC$160.911
SD$166.571
TN$157.441
TX$159.78–$176.358
UT$162.991
VA$166.76–$193.882
VI$171.501
VT$166.411
WA$175.64–$197.522
WI$161.671
WV$158.001
WY$168.871

See 38505 in every payment locality

How the 38505 rate is calculated

Each of 38505’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 · 38505

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.55

1.55 RVUs× 1.000 GPCI

Practice expense3.38

3.38 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

5.1000

Conversion factor

$33.4009

Medicare rate

$170.34

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,742

Code
38505
Physician work
1.55
Practice expense
3.38
Malpractice
0.17

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 38505 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.55× 1.0001.5500
Practice expense3.38× 1.0113.4172
Malpractice0.17× 0.9850.1675
Total RVUs5.1346
Conversion factor× 33.4009

Office rate, Puerto Rico$171.50

Office: (1.55 × 1 + 3.38 × 1.011 + 0.17 × 0.985) × $33.4009 = $171.50

Facility: (1.55 × 1 + 0.52 × 1.011 + 0.17 × 0.985) × $33.4009 = $74.92

Open 38505 in the RVU calculator

Payment rules and modifiers for 38505

The CMS indicators that decide how 38505 is paid alongside other services.

CMS payment indicators · 38505

Lymph node biopsy, needle, superficial node

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

38505 without 50 · national office

$170.34

Lymph node biopsy, needle, superficial node

38505-50 · Bilateral: 150%

$255.51

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 38505

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

Codes related to 38505
CodeHow it relatesOffice range, Puerto Rico
Same family
38500Lymph node biopsy, open, superficial nodeOpen biopsy or removal of a superficial node, rather than needle sampling.$371.34
38510Lymph node biopsy, open, deep cervicalOpen biopsy or removal of a deep cervical node.$553.66
38525Axillary node biopsy, open, deep axillary nodesOpen biopsy or removal of a deep axillary node.No office rate

How 38505 has changed in Puerto Rico

38505 · Office / nonfacility

$171.50

Effective 2026-10-01

The base rate is $4.24 higher than on 2025-10-01, moving from $167.26 to $171.50 (2.5%).

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

    $167.26changed to$171.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.59 changed to 1.55
    • Practice expense RVU 3.40 changed to 3.38
    • Malpractice RVU 0.16 changed to 0.17
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $174.14changed to$167.26

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.46 changed to 3.40

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $171.30changed to$174.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $180.47changed to$171.30

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.54 changed to 3.46
    • Malpractice RVU 0.17 changed to 0.16
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $179.60changed to$180.47

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $185.38changed to$179.60

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.60 changed to 3.54
    • Malpractice RVU 0.14 changed to 0.17
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $126.57changed to$185.38

    • Conversion factor 34.8931 changed to 34.6062
    • Work RVU 1.14 changed to 1.59
    • Practice expense RVU 2.36 changed to 3.60
    • Malpractice RVU 0.11 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $128.73changed to$126.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.30 changed to 2.36
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $128.84changed to$128.73

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.31 changed to 2.30
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $129.43changed to$128.84

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.33 changed to 2.31

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $115.33changed to$129.43

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.34 changed to 2.33
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $101.79changed to$115.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.37 changed to 2.34
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $102.27changed to$101.79

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.12 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $101.76changed to$102.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $99.91changed to$101.76

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.34 changed to 2.37
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $98.16changed to$99.91

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.53 changed to 2.34
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $98.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$171.50$74.92RVU26D
2026-07-01$171.50$74.92RVU26C
2026-04-01$171.50$74.92RVU26B
2026-01-01$171.50$74.92RVU26A
2025-10-01$167.26$82.57RVU25D
2025-07-01$167.26$82.57RVU25C
2025-04-01$167.26$82.57RVU25B
2025-01-01$167.26$82.57RVU25A
2024-10-01$174.14$84.30RVU24D
2024-07-01$174.14$84.30RVU24C
2024-04-01$174.14$84.30RVU24B
2024-03-09$174.14$84.30RVU24AR
2024-01-01$171.30$82.93RVU24A
2023-10-01$180.47$86.19RVU23D
2023-07-01$179.60$86.07RVU23C
2023-04-01$179.60$86.07RVU23B
2023-01-01$179.60$86.07RVU23A
2022-10-01$185.38$86.66RVU22D
2022-07-01$185.38$86.66RVU22C
2022-04-01$185.38$86.66RVU22B
2022-01-01$185.38$86.66RVU22A
2021-10-01$126.57$70.65RVU21D
2021-07-01$126.57$70.65RVU21C
2021-04-01$126.57$70.65RVU21B
2021-01-01$126.57$70.65RVU21A
2020-10-01$128.73$73.08RVU20D
2020-07-01$128.73$73.08RVU20C
2020-04-01$128.73$73.08RVU20B
2020-01-01$128.73$73.08RVU20A
2019-10-01$128.84$72.95RVU19D
2019-07-01$128.84$72.95RVU19C
2019-04-01$128.84$72.95RVU19B
2019-01-01$128.84$72.95RVU19A
2018-10-01$129.43$73.60RVU18D
2018-07-01$129.43$73.60RVU18C
2018-04-01$129.43$73.60RVU18B
2018-01-01$129.43$73.60RVU18AR1
2017-10-01$115.33$68.33RVU17D
2017-07-01$115.33$68.33RVU17C
2017-04-01$115.33$68.33RVU17B
2017-01-01$115.33$68.33RVU17A
2016-10-01$101.79$62.42RVU16D
2016-07-01$101.79$62.42RVU16C
2016-04-01$101.79$62.42RVU16B
2016-01-01$101.79$62.42RVU16A
2015-10-01$102.27$62.75RVU15D
2015-07-01$102.27$62.75RVU15C
2015-04-01$101.76$62.44RVU15B
2015-01-01$101.76$62.44RVU15A
2014-10-01$99.91$61.99RVU14D
2014-07-01$99.91$61.99RVU14C
2014-04-01$99.91$61.99RVU14B
2014-01-01$99.91$61.99RVU14A
2013-10-01$98.16$59.64RVU13D
2013-07-01$98.16$59.64RVU13C
2013-04-01$98.16$59.64RVU13B
2013-01-01$98.16$59.64RVU13AR

Price 38505 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

38505 billing questions

When should 38505 be used instead of 38500?

Use 38505 for needle sampling of a superficial lymph node. Code 38500 describes an open biopsy or removal of a superficial node.

How does 38505 differ from fine needle aspiration?

38505 represents needle biopsy of a superficial node, commonly performed to obtain tissue. Fine needle aspiration codes apply when the service is aspiration sampling, with code selection depending on whether imaging guidance is used.

Can modifier 50 be reported for bilateral node biopsies?

Yes. CMS identifies 38505 as bilateral, and modifier 50 results in payment at 150% when the procedure is performed bilaterally.

Does the code include same-day postoperative care?

Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be paid for 38505?

Medicare does not pay an assistant at surgery 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 38505PPRRVU2026_Oct_nonQPP.csv, line 4,742 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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