CPT code 38530: Lymph node biopsy, internal mammary nodes2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 38530 in California.

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

What 38530 covers

This code describes an open operation to sample or remove one or more internal mammary lymph nodes, located along the internal thoracic vessels behind the anterior chest wall. A surgeon, commonly a breast or thoracic surgeon, performs the procedure in an operating room when tissue from this specific nodal basin is needed for diagnosis or staging. The approach involves surgical exposure, rather than needle sampling or removal of an axillary, cervical, or superficial node.

Choose the code based on the documented internal mammary site and open technique. The operative report should identify the side, nodal basin, approach, and tissue sampled or removed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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.

Where 38530 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 38530 rate is calculated

Each of 38530’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 38530

38530 has a 90-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

38530 compared with similar codes

How to choose

38525Axillary node biopsyOpen, deep axillary nodes

Use 38525 for open sampling or removal of deep axillary nodes. This code identifies the internal mammary nodal basin.

38510Lymph node biopsyOpen, deep cervical

Use 38510 for open biopsy or removal of deep cervical nodes; this code is for internal mammary nodes.

38505Lymph node biopsyNeedle, superficial node

38505 describes needle biopsy of a superficial node. This code describes open surgical sampling or removal of internal mammary node tissue.

Codes related to 38530

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

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