CPT code 38746: Lymph node dissection, thoracic regional nodes2026 Medicare rate & RVUs in Utah
Report this add-on for regional thoracic lymph node dissection, such as mediastinal and peritracheal node removal performed with a primary thoracic operation.
In Utah, Medicare pays $190.30 for 38746 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 38746 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 38746 covers
This service captures regional removal of thoracic lymph nodes, including mediastinal and peritracheal nodes, during a thoracic operation. A thoracic surgeon commonly performs it as part of lung cancer surgery, such as a lobectomy, in a hospital operating room. The lymph node dissection is distinct from the operation that provides access to or removes lung tissue.
Report 38746 only with a qualifying primary procedure; it is not a stand-alone service. The operative report should support that a regional thoracic lymphadenectomy was performed and identify the nodal area or stations addressed. The CMS add-on rule places payment for this service within the primary procedure’s global period. Examples of primary procedures with which it may be reported include open or thoracoscopic lung resection, when the documented work supports the separate add-on.
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 Utah compares for 38746
Across 109 of 109 payment localities, the facility rate for 38746 runs from $170.68 in Wisconsin to $248.99 in Alaska. Utah pays $190.30. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Utah · this page$190.30
- Los Angeles, CA · California$194.40+$4.10
- Washington, DC area · District of Columbia$211.31+$21.01
- Miami, FL · Florida$248.60+$58.30
- Chicago, IL · Illinois$240.59+$50.29
- Manhattan, NY · New York$228.34+$38.04
- Alaska · Alaska$248.99+$58.69
Other areas in Utah first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $177.23 |
| ArkansasArkansas | — | $175.06 |
| ArizonaArizona | — | $189.65 |
| Bakersfield, CACalifornia | — | $187.22 |
| Chico, CACalifornia | — | $184.47 |
| El Centro, CACalifornia | — | $184.64 |
| Fresno, CACalifornia | — | $184.47 |
| Hanford, CACalifornia | — | $184.47 |
| Madera, CACalifornia | — | $184.47 |
| Merced, CACalifornia | — | $184.47 |
| Modesto, CACalifornia | — | $184.47 |
| Napa, CACalifornia | — | $195.70 |
| Oxnard, CACalifornia | — | $191.23 |
| Redding, CACalifornia | — | $184.47 |
| Rest of CaliforniaCalifornia | — | $184.47 |
| Riverside, CACalifornia | — | $195.40 |
| Sacramento, CACalifornia | — | $188.83 |
| Salinas, CACalifornia | — | $188.05 |
| San Diego, CACalifornia | — | $189.12 |
| Marin County, CACalifornia | — | $200.81 |
| San Francisco, CACalifornia | — | $199.65 |
| San Benito County, CACalifornia | — | $206.32 |
| Santa Clara County, CACalifornia | — | $201.58 |
| San Luis Obispo, CACalifornia | — | $185.63 |
| Santa Cruz, CACalifornia | — | $188.22 |
| Santa Maria, CACalifornia | — | $187.84 |
| Santa Rosa, CACalifornia | — | $189.78 |
| Stockton, CACalifornia | — | $184.47 |
| Vallejo, CACalifornia | — | $194.03 |
| Visalia, CACalifornia | — | $184.47 |
| Yuba City, CACalifornia | — | $184.47 |
| ColoradoColorado | — | $191.28 |
| ConnecticutConnecticut | — | $207.32 |
| DelawareDelaware | — | $192.30 |
| Fort Lauderdale, FLFlorida | — | $223.27 |
| Rest of FloridaFlorida | — | $211.34 |
| Atlanta, GAGeorgia | — | $203.08 |
| Rest of GeorgiaGeorgia | — | $199.01 |
| Hawaii, Guam, HIHawaii | — | $184.76 |
| IowaIowa | — | $172.55 |
| IdahoIdaho | — | $175.28 |
| East St. Louis, ILIllinois | — | $227.78 |
| Rest of IllinoisIllinois | — | $212.22 |
| Suburban Chicago, ILIllinois | — | $223.37 |
| IndianaIndiana | — | $175.91 |
| KansasKansas | — | $175.90 |
| KentuckyKentucky | — | $189.50 |
| New Orleans, LALouisiana | — | $198.43 |
| Rest of LouisianaLouisiana | — | $190.85 |
| Metropolitan Boston, MAMassachusetts | — | $202.40 |
| Rest of MassachusettsMassachusetts | — | $192.06 |
| Baltimore area, MDMaryland | — | $207.59 |
| Rest of MarylandMaryland | — | $194.27 |
| Rest of MaineMaine | — | $180.35 |
| Southern Maine, MEMaine | — | $182.58 |
| Detroit, MIMichigan | — | $217.82 |
| Rest of MichiganMichigan | — | $197.44 |
| MinnesotaMinnesota | — | $172.20 |
| Metropolitan Kansas City, MOMissouri | — | $192.96 |
| Metropolitan St. Louis, MOMissouri | — | $194.16 |
| Rest of MissouriMissouri | — | $190.78 |
| MississippiMississippi | — | $182.74 |
| MontanaMontana | — | $195.33 |
| North CarolinaNorth Carolina | — | $181.28 |
| North DakotaNorth Dakota | — | $175.16 |
| NebraskaNebraska | — | $172.12 |
| New HampshireNew Hampshire | — | $192.25 |
| Northern New JerseyNew Jersey | — | $210.50 |
| Rest of New JerseyNew Jersey | — | $206.56 |
| New MexicoNew Mexico | — | $200.00 |
| NevadaNevada | — | $189.73 |
| NYC suburbs and Long Island, NYNew York | — | $238.30 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $211.16 |
| Queens, NYNew York | — | $223.97 |
| Rest of New YorkNew York | — | $183.92 |
| OhioOhio | — | $193.31 |
| OklahomaOklahoma | — | $184.90 |
| Portland, OROregon | — | $191.83 |
| Rest of OregonOregon | — | $185.17 |
| Metropolitan Philadelphia, PAPennsylvania | — | $205.50 |
| Rest of PennsylvaniaPennsylvania | — | $191.30 |
| Puerto RicoPuerto Rico | — | $195.18 |
| Rhode IslandRhode Island | — | $195.16 |
| South CarolinaSouth Carolina | — | $188.23 |
| South DakotaSouth Dakota | — | $172.77 |
| TennesseeTennessee | — | $177.16 |
| Austin, TXTexas | — | $193.35 |
| Beaumont, TXTexas | — | $190.54 |
| Brazoria, TXTexas | — | $188.73 |
| Dallas, TXTexas | — | $191.66 |
| Fort Worth, TXTexas | — | $191.83 |
| Galveston, TXTexas | — | $190.42 |
| Houston, TXTexas | — | $209.09 |
| Rest of TexasTexas | — | $190.71 |
| VirginiaVirginia | — | $184.92 |
| Virgin Islands, VIUnited States Virgin Islands | — | $195.18 |
| VermontVermont | — | $178.29 |
| Rest of WashingtonWashington | — | $190.43 |
| King County, WAWashington | — | $202.02 |
| WisconsinWisconsin | — | $170.68 |
| West VirginiaWest Virginia | — | $206.53 |
| WyomingWyoming | — | $186.54 |
38746 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 38746 rate is calculated
Each of 38746’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 · 38746
RVUs × geographic indexes × conversion factor
Work4.02
4.02 RVUs× 1.000 GPCI
Practice expense0.81
0.81 RVUs× 1.000 GPCI
Malpractice1.02
1.02 RVUs× 1.000 GPCI
Adjusted RVUs
5.8500
Conversion factor
$33.4009
Medicare rate
$195.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Utah inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,763
- Code
- 38746
- Physician work
- 4.02
- Practice expense
- 0.81
- Malpractice
- 1.02
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.02 | × 1.000 | 4.0200 |
| Practice expense | 0.81 | × 0.940 | 0.7614 |
| Malpractice | 1.02 | × 0.898 | 0.9160 |
| Total RVUs | 5.6974 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$190.30
Facility: (4.02 × 1 + 0.81 × 0.94 + 1.02 × 0.898) × $33.4009 = $190.30
Payment rules and modifiers for 38746
The CMS indicators that decide how 38746 is paid alongside other services.
CMS payment indicators · 38746
Lymph node dissection, thoracic regional nodes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
38746 without 80 · national facility
$195.40
Lymph node dissection, thoracic regional nodes
38746-80 · Assistant: 16%
$31.26
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
How 38746 has changed in Utah
38746 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $190.30 | RVU26D |
| 2026-07-01 | Not available in this setting | $190.30 | RVU26C |
| 2026-04-01 | Not available in this setting | $190.30 | RVU26B |
| 2026-01-01 | Not available in this setting | $190.30 | RVU26A |
| 2025-10-01 | Not available in this setting | $198.96 | RVU25D |
| 2025-07-01 | Not available in this setting | $198.96 | RVU25C |
| 2025-04-01 | Not available in this setting | $198.96 | RVU25B |
| 2025-01-01 | Not available in this setting | $198.96 | RVU25A |
| 2024-10-01 | Not available in this setting | $204.44 | RVU24D |
| 2024-07-01 | Not available in this setting | $204.44 | RVU24C |
| 2024-04-01 | Not available in this setting | $204.44 | RVU24B |
| 2024-03-09 | Not available in this setting | $204.44 | RVU24AR |
| 2024-01-01 | Not available in this setting | $201.10 | RVU24A |
| 2023-10-01 | Not available in this setting | $204.76 | RVU23D |
| 2023-07-01 | Not available in this setting | $204.76 | RVU23C |
| 2023-04-01 | Not available in this setting | $204.76 | RVU23B |
| 2023-01-01 | Not available in this setting | $204.76 | RVU23A |
| 2022-10-01 | Not available in this setting | $207.84 | RVU22D |
| 2022-07-01 | Not available in this setting | $207.84 | RVU22C |
| 2022-04-01 | Not available in this setting | $207.84 | RVU22B |
| 2022-01-01 | Not available in this setting | $207.84 | RVU22A |
| 2021-10-01 | Not available in this setting | $209.05 | RVU21D |
| 2021-07-01 | Not available in this setting | $209.05 | RVU21C |
| 2021-04-01 | Not available in this setting | $209.05 | RVU21B |
| 2021-01-01 | Not available in this setting | $209.05 | RVU21A |
| 2020-10-01 | Not available in this setting | $220.62 | RVU20D |
| 2020-07-01 | Not available in this setting | $220.62 | RVU20C |
| 2020-04-01 | Not available in this setting | $220.62 | RVU20B |
| 2020-01-01 | Not available in this setting | $220.62 | RVU20A |
| 2019-10-01 | Not available in this setting | $227.12 | RVU19D |
| 2019-07-01 | Not available in this setting | $227.12 | RVU19C |
| 2019-04-01 | Not available in this setting | $227.12 | RVU19B |
| 2019-01-01 | Not available in this setting | $227.12 | RVU19A |
| 2018-10-01 | Not available in this setting | $226.79 | RVU18D |
| 2018-07-01 | Not available in this setting | $226.79 | RVU18C |
| 2018-04-01 | Not available in this setting | $226.79 | RVU18B |
| 2018-01-01 | Not available in this setting | $226.79 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $226.74 | RVU17D |
| 2017-07-01 | Not available in this setting | $226.74 | RVU17C |
| 2017-04-01 | Not available in this setting | $226.74 | RVU17B |
| 2017-01-01 | Not available in this setting | $226.74 | RVU17A |
| 2016-10-01 | Not available in this setting | $226.89 | RVU16D |
| 2016-07-01 | Not available in this setting | $226.89 | RVU16C |
| 2016-04-01 | Not available in this setting | $226.89 | RVU16B |
| 2016-01-01 | Not available in this setting | $226.89 | RVU16A |
| 2015-10-01 | Not available in this setting | $228.04 | RVU15D |
| 2015-07-01 | Not available in this setting | $228.04 | RVU15C |
| 2015-04-01 | Not available in this setting | $226.91 | RVU15B |
| 2015-01-01 | Not available in this setting | $226.91 | RVU15A |
| 2014-10-01 | Not available in this setting | $225.19 | RVU14D |
| 2014-07-01 | Not available in this setting | $225.19 | RVU14C |
| 2014-04-01 | Not available in this setting | $225.19 | RVU14B |
| 2014-01-01 | Not available in this setting | $225.19 | RVU14A |
| 2013-10-01 | Not available in this setting | $217.93 | RVU13D |
| 2013-07-01 | Not available in this setting | $217.93 | RVU13C |
| 2013-04-01 | Not available in this setting | $217.93 | RVU13B |
| 2013-01-01 | Not available in this setting | $217.93 | RVU13AR |
Where the Utah rate applies
Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.
- Alpine
- Alta
- Altamont
- Alton
- Amalga
- American Fork
- Aneth
- Annabella
38746 billing questions
Can 38746 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure.
What documentation supports reporting 38746?
The operative report should describe the regional thoracic lymph node dissection and identify the nodal area or stations addressed.
Is 38746 included in the lung resection code?
It represents the additional regional lymphadenectomy work and is reported with the primary thoracic procedure when that work was performed and documented.
How does CMS handle the global period?
CMS treats 38746 as an add-on paid within the global period of its primary procedure.
Is 38746 used for abdominal node removal?
No. It is for thoracic regional nodes; 38747 is the related add-on for regional abdominal lymphadenectomy.
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
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