CPT code 38747: Abdominal lymphadenectomy, regional upper abdominal nodes2026 Medicare rate & RVUs in Texas
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 doesn’t publish an office rate for 38747 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $237.63 |
| Beaumont, TX | Unavailable | $232.99 |
| Brazoria, TX | Unavailable | $231.65 |
| Dallas, TX | Unavailable | $235.11 |
| Fort Worth, TX | Unavailable | $235.22 |
| Galveston, TX | Unavailable | $233.63 |
| Houston, TX | Unavailable | $255.42 |
| Rest of Texas | Unavailable | $233.55 |
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
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
| 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
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.
38747 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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