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CPT code 38510: Lymph node biopsy, open, deep cervical2026 Medicare rate & RVUs in Virginia

Reports open biopsy or excision of deep cervical lymph nodes when a surgeon obtains nodal tissue for diagnosis, such as evaluating suspected lymphoma or metastatic disease.

CMS RVU26DEffective Oct 1, 2026One payment locality6.7K Medicare services in 2024

In Virginia, Medicare pays $533.73 for 38510 in the office and $363.65 when it’s performed in a hospital or facility.

$533.73Office (non-facility)
$363.65Hospital or facility
−3.2%vs the national office rate ($551.11)

Check a contract rate as a % of Medicare · 38510 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 38510 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 38510 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 38510 covers

This code covers an open surgical biopsy or removal of one or more deep cervical lymph nodes, commonly from the deep neck chain. An otolaryngologist, head and neck surgeon, or general surgeon may perform it when imaging or examination identifies a node requiring tissue diagnosis, including workup for suspected lymphoma or metastatic cancer. The node is submitted for pathologic examination; this is different from sampling a superficial neck node or using a needle approach.

Report the code for the open deep cervical procedure, documenting the node’s location, the operative approach, and whether biopsy or excision was performed. The 10-day global period includes related postoperative visits during that period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. For bilateral work, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 Virginia compares for 38510

Across 109 of 109 payment localities, the office rate for 38510 runs from $489.76 in Arkansas to $683.42 in San Benito County, CA. Virginia pays $533.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

38510 in Virginia vs other payment areas
  1. Virginia · this page$533.73
  2. Los Angeles, CA · California$598.79+$65.06
  3. Washington, DC area · District of Columbia$619.25+$85.52
  4. Miami, FL · Florida$627.83+$94.10
  5. Chicago, IL · Illinois$609.03+$75.30
  6. Manhattan, NY · New York$636.88+$103.15
  7. Alaska · Alaska$660.59+$126.86

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

Every other payment area

38510 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$496.55$345.16
ArkansasArkansas$489.76$341.14
ArizonaArizona$536.04$368.39
Bakersfield, CACalifornia$566.47$376.84
Chico, CACalifornia$562.93$373.30
El Centro, CACalifornia$563.14$373.52
Fresno, CACalifornia$562.93$373.30
Hanford, CACalifornia$562.93$373.30

38510 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.

$489.76

$660.59

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

View every state and territory as a table
38510 office rate range by state
State / territoryOffice rate rangeLocalities
AK$660.591
AL$496.551
AR$489.761
AZ$536.041
CA$562.93–$683.4229
CO$562.971
CT$586.681
DC$619.251
DE$544.461
FL$559.72–$627.833
GA$528.02–$564.932
GU$572.881
HI$572.881
IA$500.951
ID$505.621
IL$549.83–$609.034
IN$508.201
KS$502.311
KY$515.401
LA$516.07–$539.822
MA$561.35–$611.562
MD$553.30–$619.253
ME$511.94–$532.862
MI$531.42–$570.092
MN$529.641
MO$510.10–$537.323
MS$499.841
MT$551.031
NC$516.421
ND$525.921
NE$502.461
NH$557.671
NJ$590.62–$614.102
NM$535.631
NV$544.321
NY$524.05–$656.185
OH$526.291
OK$510.711
OR$537.36–$575.872
PA$525.06–$575.112
PR$553.661
RI$560.251
SC$522.771
SD$522.951
TN$505.151
TX$522.07–$566.808
UT$529.431
VA$533.73–$619.252
VI$553.661
VT$527.271
WA$559.16–$619.982
WI$509.611
WV$531.511
WY$540.091

See 38510 in every payment locality

How the 38510 rate is calculated

Each of 38510’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 · 38510

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.57

6.57 RVUs× 1.000 GPCI

Practice expense8.66

8.66 RVUs× 1.000 GPCI

Malpractice1.27

1.27 RVUs× 1.000 GPCI

Adjusted RVUs

16.5000

Conversion factor

$33.4009

Medicare rate

$551.11

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,743

Code
38510
Physician work
6.57
Practice expense
8.66
Malpractice
1.27

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 38510 in Virginia
ComponentRVULocality factorAdjusted
Physician work6.57× 1.0006.5700
Practice expense8.66× 0.9838.5128
Malpractice1.27× 0.7060.8966
Total RVUs15.9794
Conversion factor× 33.4009

Office rate, Virginia$533.73

Office: (6.57 × 1 + 8.66 × 0.983 + 1.27 × 0.706) × $33.4009 = $533.73

Facility: (6.57 × 1 + 3.48 × 0.983 + 1.27 × 0.706) × $33.4009 = $363.65

Open 38510 in the RVU calculator

Payment rules and modifiers for 38510

38510 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38510

Lymph node biopsy, open, deep cervical

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 · 38510

Lymph node biopsy, open, deep cervical

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

38510 without 50 · national office

$551.11

Lymph node biopsy, open, deep cervical

38510-50 · Bilateral: 150%

$826.67

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 38510

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

Codes related to 38510
CodeHow it relatesOffice range, Virginia
Same family
38500Lymph node biopsy, open, superficial nodeOpen biopsy or excision of superficial lymph nodes rather than deep cervical nodes.$356.91
38520Lymph node biopsy, deep cervical with scalene fat padOpen deep cervical node procedure that includes the scalene fat pad.No office rate
Used instead
38505Lymph node biopsy, needle, superficial nodePercutaneous needle sampling of a lymph node instead of open deep cervical biopsy.$166.76
38525Axillary node biopsy, open, deep axillary nodesOpen biopsy or excision of deep axillary nodes rather than deep cervical nodes.No office rate
38531Groin node surgery, open inguinofemoral nodesOpen biopsy or excision of inguinofemoral nodes at a different anatomic site.No office rate

How 38510 has changed in Virginia

38510 · Office / nonfacility

$533.73

Effective 2026-10-01

The base rate is $34.16 higher than on 2025-10-01, moving from $499.57 to $533.73 (6.8%).

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

    $499.57changed to$533.73

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.74 changed to 6.57
    • Practice expense RVU 7.85 changed to 8.66
    • Malpractice RVU 1.28 changed to 1.27
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $515.34changed to$499.57

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.88 changed to 7.85
    • Malpractice RVU 1.29 changed to 1.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $506.92changed to$515.34

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $528.59changed to$506.92

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 1.28 changed to 1.29
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $541.87changed to$528.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.80 changed to 7.88
    • Malpractice RVU 1.29 changed to 1.28
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $539.21changed to$541.87

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.63 changed to 7.80
    • Malpractice RVU 1.25 changed to 1.29

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $538.27changed to$539.21

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.11 changed to 7.63
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $531.04changed to$538.27

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.93 changed to 7.11
    • Malpractice RVU 1.28 changed to 1.25
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $524.73changed to$531.04

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.75 changed to 6.93
    • Malpractice RVU 1.30 changed to 1.28

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $523.74changed to$524.73

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.83 changed to 6.75
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $523.11changed to$523.74

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.90 changed to 6.83
    • Malpractice RVU 1.32 changed to 1.30
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $523.65changed to$523.11

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.87 changed to 6.90
    • Malpractice RVU 1.31 changed to 1.32

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $521.04changed to$523.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $517.06changed to$521.04

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.93 changed to 6.87
    • Malpractice RVU 1.16 changed to 1.31
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $515.36changed to$517.06

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.70 changed to 6.93
    • Malpractice RVU 1.21 changed to 1.16
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $515.36

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$533.73$363.65RVU26D
2026-07-01$533.73$363.65RVU26C
2026-04-01$533.73$363.65RVU26B
2026-01-01$533.73$363.65RVU26A
2025-10-01$499.57$397.08RVU25D
2025-07-01$499.57$397.08RVU25C
2025-04-01$499.57$397.08RVU25B
2025-01-01$499.57$397.08RVU25A
2024-10-01$515.34$406.26RVU24D
2024-07-01$515.34$406.26RVU24C
2024-04-01$515.34$406.26RVU24B
2024-03-09$515.34$406.26RVU24AR
2024-01-01$506.92$399.63RVU24A
2023-10-01$528.59$415.87RVU23D
2023-07-01$528.59$415.87RVU23C
2023-04-01$528.59$415.87RVU23B
2023-01-01$528.59$415.87RVU23A
2022-10-01$541.87$424.45RVU22D
2022-07-01$541.87$424.45RVU22C
2022-04-01$541.87$424.45RVU22B
2022-01-01$541.87$424.45RVU22A
2021-10-01$539.21$422.90RVU21D
2021-07-01$539.21$422.90RVU21C
2021-04-01$539.21$422.90RVU21B
2021-01-01$539.21$422.90RVU21A
2020-10-01$538.27$430.62RVU20D
2020-07-01$538.27$430.62RVU20C
2020-04-01$538.27$430.62RVU20B
2020-01-01$538.27$430.62RVU20A
2019-10-01$531.04$429.06RVU19D
2019-07-01$531.04$429.06RVU19C
2019-04-01$531.04$429.06RVU19B
2019-01-01$531.04$429.06RVU19A
2018-10-01$524.73$427.47RVU18D
2018-07-01$524.73$427.47RVU18C
2018-04-01$524.73$427.47RVU18B
2018-01-01$524.73$427.47RVU18AR1
2017-10-01$523.74$426.52RVU17D
2017-07-01$523.74$426.52RVU17C
2017-04-01$523.74$426.52RVU17B
2017-01-01$523.74$426.52RVU17A
2016-10-01$523.11$425.27RVU16D
2016-07-01$523.11$425.27RVU16C
2016-04-01$523.11$425.27RVU16B
2016-01-01$523.11$425.27RVU16A
2015-10-01$523.65$425.10RVU15D
2015-07-01$523.65$425.10RVU15C
2015-04-01$521.04$422.98RVU15B
2015-01-01$521.04$422.98RVU15A
2014-10-01$517.06$419.82RVU14D
2014-07-01$517.06$419.82RVU14C
2014-04-01$517.06$419.82RVU14B
2014-01-01$517.06$419.82RVU14A
2013-10-01$515.36$410.99RVU13D
2013-07-01$515.36$410.99RVU13C
2013-04-01$515.36$410.99RVU13B
2013-01-01$515.36$410.99RVU13AR

Price 38510 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

38510 billing questions

How does this differ from 38500?

38510 is for open work on deep cervical nodes. Code 38500 applies to open biopsy or excision of superficial lymph nodes.

Can 38510 be used for a needle biopsy?

No. For percutaneous needle sampling of a lymph node, consider 38505; 38510 describes an open surgical approach to deep cervical nodes.

When is 38520 more appropriate?

38520 describes open deep cervical node work that includes the scalene fat pad. Use 38510 when that additional tissue is not part of the procedure.

How is bilateral deep cervical work reported?

The CMS payment rule identifies modifier 50 for bilateral procedures and pays the procedure at 150%. Document the work on both sides.

Are postoperative visits included?

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

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 38510. 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 38510PPRRVU2026_Oct_nonQPP.csv, line 4,743 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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