CPT code 38770: Pelvic lymphadenectomy, external iliac, hypogastric, obturator2026 Medicare rate & RVUs in Massachusetts
Reports open removal of pelvic lymph nodes, including external iliac, hypogastric, and obturator nodes, during surgery for cancers such as prostate or gynecologic malignancies.
CMS doesn’t publish an office rate for 38770 in Massachusetts.
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 38770 covers
This code describes an open pelvic lymphadenectomy involving nodal tissue in the external iliac, hypogastric, and obturator regions. Urologists and gynecologic oncologists commonly perform it during cancer surgery, such as prostate, bladder, or gynecologic cancer operations. The service is distinct from removing groin nodes or performing a laparoscopic pelvic dissection. The operative report should identify the pelvic nodal fields dissected and the extent of the removal.
Report the code when the documented operation includes this pelvic lymph node dissection, rather than a limited sentinel-node procedure or a dissection confined to another region. It has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 38770 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $789.04 |
| Rest of Massachusetts | Unavailable | $741.64 |
How the 38770 rate is calculated
Each of 38770’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 · 38770
RVUs × geographic indexes × conversion factor
Work13.71
13.71 RVUs× 1.000 GPCI
Practice expense6.11
6.11 RVUs× 1.000 GPCI
Malpractice2.31
2.31 RVUs× 1.000 GPCI
Adjusted RVUs
22.1300
Conversion factor
$33.4009
Medicare rate
$739.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38770
38770 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 38770
Pelvic lymphadenectomy, external iliac, hypogastric, obturator
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
| Split (54/55/56) | 0.11/0.73/0.16 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 38770
Pelvic lymphadenectomy, external iliac, hypogastric, obturator
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
38770 without 50 · national facility
$739.16
Pelvic lymphadenectomy, external iliac, hypogastric, obturator
38770-50 · Bilateral: 150%
$1,108.74
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).
38770 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 38571Pelvic lymphadenectomyLaparoscopic, bilateral
- Use 38571 for laparoscopic bilateral total pelvic lymphadenectomy; this code describes an open pelvic dissection.
- 38572Laparoscopic lymphadenectomyPelvic dissection plus para-aortic sampling
- Use 38572 when the laparoscopic pelvic dissection also includes peri-aortic node sampling. This code describes open pelvic lymphadenectomy.
- 38780Abdominal node dissectionExtensive retroperitoneal dissection
- This code covers pelvic nodal dissection. 38780 is for a retroperitoneal lymph node dissection with a broader abdominal nodal field.
- 38760Groin lymphadenectomySuperficial, includes Cloquet's node
- This code covers pelvic nodes; 38760 is for superficial inguinal nodes in the groin.
38770 billing questions
How does this differ from a laparoscopic pelvic lymphadenectomy?
This code describes an open pelvic dissection. For a laparoscopic total pelvic lymphadenectomy, consider the laparoscopic code that matches the documented extent.
Which nodal regions support reporting this code?
The operative documentation should support dissection of pelvic nodes in the external iliac, hypogastric, and obturator regions. A procedure limited to groin nodes is coded differently.
Does the code have a global period?
Yes. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral performance reported?
CMS pays bilateral performance reported with modifier 50 at 150%. The operative record should support dissection on both sides.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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
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