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CPT code 38747: Abdominal lymphadenectomy, regional upper abdominal nodes2026 Medicare rate & RVUs

Reports regional removal of abdominal lymph nodes, such as celiac, superior mesenteric, and para-aortic nodes, as an add-on to a primary operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare pays $239.48 for 38747 nationally in a facility.

Medicare rate · 38747

Abdominal lymphadenectomy, regional upper abdominal nodes

Office or facility?

Work RVUs
4.76
Total RVUs
7.17
Global days
ZZZ

National rate · 2026

$239.48

Facility setting, before claim adjustments.

See every locality for 38747 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 38747 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 38747 covers

This add-on describes regional lymph node removal in the abdomen, including nodes in the celiac, superior mesenteric, and para-aortic areas. A surgeon may perform it during an operation for an abdominal malignancy when nodal tissue is removed for treatment or staging. General surgeons and surgical oncologists commonly perform these dissections; other surgical specialists may do so when treating cancers within their fields.

Report 38747 only with a primary procedure. The operative report should identify the abdominal nodal basin removed and describe the dissection sufficiently to distinguish regional node removal from a more extensive retroperitoneal dissection. CMS pays the add-on within the primary procedure’s global period, so related postoperative care is governed by that primary procedure’s global period. A pelvic-only dissection or a dissection involving broader retroperitoneal and pelvic basins may point to a different code.

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 38747 pays more and less

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

109 of 109 payment localities

38747 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$217.14
AlaskaUnavailable$303.78
ArizonaUnavailable$232.50
ArkansasUnavailable$214.46
Atlanta, GAUnavailable$248.60
Austin, TXUnavailable$237.63
Bakersfield, CAUnavailable$230.88
Baltimore area, MDUnavailable$254.42
Beaumont, TXUnavailable$232.99
Brazoria, TXUnavailable$231.65

38747 rates by state

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

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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
38747 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 38747 rate is calculated

Each of 38747’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 · 38747

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.76

4.76 RVUs× 1.000 GPCI

Practice expense1.22

1.22 RVUs× 1.000 GPCI

Malpractice1.19

1.19 RVUs× 1.000 GPCI

Adjusted RVUs

7.1700

Conversion factor

$33.4009

Medicare rate

$239.48

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

Payment rules and modifiers for 38747

The CMS indicators that decide how 38747 is paid alongside other services.

CMS payment indicators · 38747

Abdominal lymphadenectomy, regional upper abdominal nodes

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

38747 without 80 · national facility

$239.48

Abdominal lymphadenectomy, regional upper abdominal nodes

38747-80 · Assistant: 16%

$38.32

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

38747 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 38747

    Abdominal lymphadenectomy, regional upper abdominal nodes4.76 wRVU

    Not priced

  • 38780

    Abdominal node dissection, extensive retroperitoneal dissection17.26 wRVU

    Not priced

  • 38770

    Pelvic lymphadenectomy, external iliac, hypogastric, obturator13.71 wRVU

    Not priced

  • 38746

    Lymph node dissection, thoracic regional nodes4.02 wRVU

    Not priced

How to choose

38780Abdominal node dissectionExtensive retroperitoneal dissection
Choose 38747 for regional abdominal nodal removal. 38780 describes a more extensive transabdominal retroperitoneal dissection that includes pelvic, para-aortic, and iliac nodes.
38770Pelvic lymphadenectomyExternal iliac, hypogastric, obturator
38770 is for pelvic lymphadenectomy, including specified pelvic nodal groups; 38747 is for regional abdominal nodes such as celiac and superior mesenteric nodes.
38746Lymph node dissectionThoracic regional nodes
38746 describes regional thoracic lymphadenectomy. Use 38747 when the nodal dissection is in the abdomen.

Codes related to 38747

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

Codes related to 38747
CodeHow it relatesNational office range
Used instead
38780Abdominal node dissection, extensive retroperitoneal dissectionFor extensive transabdominal retroperitoneal dissection involving pelvic, para-aortic, and iliac nodes.No office rate
38770Pelvic lymphadenectomy, external iliac, hypogastric, obturatorFor pelvic lymphadenectomy involving external iliac, hypogastric, and obturator nodes.No office rate
Same family
38746Lymph node dissection, thoracic regional nodesRegional lymphadenectomy code for thoracic rather than abdominal nodes.No office rate

38747 billing questions

Can 38747 be reported by itself?

No. It is an add-on code and must be reported with a primary procedure.

What should the operative note document?

Identify the abdominal nodal basin removed, such as celiac, superior mesenteric, or para-aortic nodes, and describe the extent of the dissection.

How does 38747 differ from 38780?

38747 describes regional abdominal lymph node removal. 38780 is for an extensive transabdominal retroperitoneal dissection that includes pelvic, para-aortic, and iliac nodes.

Does 38747 include pelvic lymph nodes?

It identifies regional abdominal nodes, not a pelvic-only dissection. For pelvic lymphadenectomy, consider 38770 when its service description matches the operation.

How does the global period affect this add-on?

The add-on is reported with a primary procedure, and its payment falls within that procedure’s global period. Related postoperative care is governed by the primary procedure’s global period.

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 38747PPRRVU2026_Oct_nonQPP.csv, line 4,764 (RVU26D)

Open CMS sourceHow we calculate rates

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