CPT code 38780: Abdominal node dissection, extensive retroperitoneal dissection2026 Medicare rate & RVUs in Missouri

Reports extensive transabdominal retroperitoneal node removal across pelvic, aortic, and renal fields for selected malignancies requiring broad nodal clearance.

CMS RVU26DEffective Oct 1, 20263 payment localities465 Medicare services in 2024

CMS doesn’t publish an office rate for 38780 in Missouri.

—Office (non-facility)
$936.79–$965.62Hospital or facility

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 9 sections
  1. Rate in Missouri
  2. What 38780 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 38780 covers

Code 38780 represents an extensive transabdominal operation to remove lymphatic tissue across the retroperitoneum, reaching pelvic, aortic, and renal nodal fields rather than a limited regional basin. Urologists and surgical oncologists commonly perform it for selected cancers requiring broad retroperitoneal clearance, including testicular malignancy; the operative report should establish the extent and nodal territories treated.

Report 38780 when the surgeon performs that extensive dissection, not for isolated sampling or a more confined pelvic or abdominal nodal clearance. Document the indication, approach, and nodal boundaries, and distinguish the work from other procedures performed in the same session. Medicare treats it as major surgery: the day-before preoperative visit and related care through 90 days after surgery are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures receive the standard reduction. Modifier 50 is inappropriate. An assistant may be paid; co-surgeons require supporting documentation, while 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 38780 pays more and less in Missouri

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

38780 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Kansas City, MOUnavailable$958.96
Metropolitan St. Louis, MOUnavailable$965.62
Rest of MissouriUnavailable$936.79

How the 38780 rate is calculated

Each of 38780’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 · 38780

RVUs × geographic indexes × conversion factor

Office or facility?

Work17.26

17.26 RVUs× 1.000 GPCI

Practice expense8.48

8.48 RVUs× 1.000 GPCI

Malpractice3.57

3.57 RVUs× 1.000 GPCI

Adjusted RVUs

29.3100

Conversion factor

$33.4009

Medicare rate

$978.98

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

Payment rules and modifiers for 38780

38780 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38780

Abdominal node dissection, extensive retroperitoneal dissection

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.11/0.73/0.16Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 38780

Abdominal node dissection, extensive retroperitoneal dissection

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

38780 without 51 · national facility

$978.98

Abdominal node dissection, extensive retroperitoneal dissection

38780-51 · Second procedure: 50%

$489.49

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

38780 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 38780

    Abdominal node dissection, extensive retroperitoneal dissection17.26 wRVU

    Not priced

  • 38747

    Abdominal lymphadenectomy, regional upper abdominal nodes4.76 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

38747Abdominal lymphadenectomyRegional upper abdominal nodes
Choose 38747 for regional abdominal nodal clearance. Use 38780 when the operation involves extensive retroperitoneal dissection across pelvic, aortic, and renal fields.
38770Pelvic lymphadenectomyExternal iliac, hypogastric, obturator
38770 is directed to pelvic nodal groups. It does not describe the broader retroperitoneal dissection represented by 38780.
38746Lymph node dissectionThoracic regional nodes
38746 covers regional thoracic nodal dissection, such as mediastinal or periesophageal fields; 38780 is for extensive abdominal retroperitoneal fields.

38780 billing questions

How is 38780 distinguished from 38747?

Use 38780 for broad retroperitoneal clearance reaching pelvic, aortic, and renal nodal fields. Code 38747 describes regional abdominal node removal rather than this extensive dissection.

Can modifier 50 be appended for bilateral work?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What postoperative care is included?

The major-surgery global period includes the day-before preoperative visit and related postoperative care for 90 days.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What documentation supports choosing 38780?

The operative report should identify the extensive retroperitoneal dissection and the nodal territories addressed, including whether pelvic, aortic, and renal fields were treated.

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 38780PPRRVU2026_Oct_nonQPP.csv, line 4,768 (RVU26D)

Open CMS sourceHow we calculate rates

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