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CPT code 38900: Sentinel node mapping, intraoperative identification2026 Medicare rate & RVUs in King County, WA

Report intraoperative sentinel lymph node mapping when the surgeon identifies sentinel nodes during cancer surgery, commonly for breast cancer or melanoma.

CMS RVU26DEffective Oct 1, 2026One payment locality50.8K Medicare services in 2024

In King County, WA, Medicare pays $155.36 for 38900 in the office and $128.31 when it’s performed in a hospital or facility.

$155.36Office (non-facility)
$128.31Hospital or facility
+7.2%vs the national office rate ($144.96)

Check a contract rate as a % of Medicare · 38900 nationwide

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

We’ll open 38900 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 38900 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 38900 covers

This add-on describes the surgeon’s intraoperative identification of sentinel lymph node(s), the first node or nodes expected to receive lymphatic drainage from a tumor site. It is commonly used during breast cancer or melanoma surgery. The surgeon may inject nonradioactive dye and identify the draining node(s) for removal; the node excision itself is represented by the applicable primary procedure code.

Report 38900 only with a primary procedure, such as an open sentinel node biopsy, and document the tumor site, mapping or identification performed, and the associated operation. The code includes injection of nonradioactive dye when performed, so that injection is not separately represented by 38900. CMS treats this as an add-on paid within the primary procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays 150% of the code’s applicable payment.

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 King County, WA compares for 38900

Across 109 of 109 payment localities, the office rate for 38900 runs from $129.23 in Arkansas to $179.70 in Alaska. King County, WA pays $155.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

38900 in King County, WA vs other payment areas
  1. King County, WA · this page$155.36
  2. Rest of Washington · Washington$143.63−$11.73
  3. Los Angeles, CA · California$149.69−$5.67
  4. Washington, DC area · District of Columbia$159.38+$4.02
  5. Miami, FL · Florida$176.89+$21.53
  6. Chicago, IL · Illinois$171.27+$15.91
  7. Manhattan, NY · New York$168.81+$13.45

Other areas in Washington first, then benchmark localities. Bars start at $0.

Every other payment area

38900 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$179.70$156.23
AlabamaAlabama$130.94$111.65
ArkansasArkansas$129.23$110.30
ArizonaArizona$140.77$119.40
Bakersfield, CACalifornia$143.00$118.84
Chico, CACalifornia$141.40$117.24
El Centro, CACalifornia$141.50$117.34
Fresno, CACalifornia$141.40$117.24

38900 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$129.23

$179.70

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
38900 office rate range by state
State / territoryOffice rate rangeLocalities
AK$179.701
AL$130.941
AR$129.231
AZ$140.771
CA$141.40–$164.1229
CO$144.421
CT$154.101
DC$159.381
DE$142.851
FL$152.95–$176.893
GA$144.02–$149.872
GU$142.661
HI$142.661
IA$129.361
ID$131.071
IL$152.25–$171.274
IN$131.641
KS$130.981
KY$138.431
LA$139.10–$145.062
MA$144.58–$154.622
MD$144.68–$159.383
ME$134.01–$137.292
MI$143.70–$156.952
MN$132.361
MO$138.41–$142.903
MS$133.731
MT$144.921
NC$134.911
ND$133.251
NE$129.331
NH$144.291
NJ$154.16–$158.442
NM$145.291
NV$141.711
NY$136.92–$175.335
OH$141.311
OK$135.881
OR$138.93–$146.082
PA$140.29–$152.022
PR$145.151
RI$145.821
SC$138.681
SD$131.871
TN$131.851
TX$139.62–$152.728
UT$140.321
VA$138.42–$159.382
VI$145.151
VT$134.791
WA$143.63–$155.362
WI$129.491
WV$147.721
WY$139.841

See 38900 in every payment locality

How the 38900 rate is calculated

Each of 38900’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 · 38900

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.44

2.44 RVUs× 1.000 GPCI

Practice expense1.31

1.31 RVUs× 1.000 GPCI

Malpractice0.59

0.59 RVUs× 1.000 GPCI

Adjusted RVUs

4.3400

Conversion factor

$33.4009

Medicare rate

$144.96

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

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,772

Code
38900
Physician work
2.44
Practice expense
1.31
Malpractice
0.59

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 38900 in King County, WA
ComponentRVULocality factorAdjusted
Physician work2.44× 1.0502.5620
Practice expense1.31× 1.2271.6074
Malpractice0.59× 0.8170.4820
Total RVUs4.6514
Conversion factor× 33.4009

Office rate, King County, WA$155.36

Office: (2.44 × 1.05 + 1.31 × 1.227 + 0.59 × 0.817) × $33.4009 = $155.36

Facility: (2.44 × 1.05 + 0.65 × 1.227 + 0.59 × 0.817) × $33.4009 = $128.31

Open 38900 in the RVU calculator

Payment rules and modifiers for 38900

The CMS indicators that decide how 38900 is paid alongside other services.

CMS payment indicators · 38900

Sentinel node mapping, intraoperative identification

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

38900 without 50 · national office

$144.96

Sentinel node mapping, intraoperative identification

38900-50 · Bilateral: 150%

$217.44

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).

When to use modifier 50

Codes related to 38900

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

Codes related to 38900
CodeHow it relatesOffice range, King County, WA
Primary code
38525Axillary node biopsy, open, deep axillary nodesOpen biopsy or excision of deep axillary node(s) may be the primary procedure.No office rate
38500Lymph node biopsy, open, superficial nodeOpen biopsy or excision of superficial lymph node(s) may be the primary procedure.$419.07
Often billed with
19301Partial mastectomy, breast-conserving excisionBreast-conserving surgery may occur in the same operation as sentinel node mapping.No office rate
38792Sentinel node injection, radioactive tracerRadioactive tracer injection may accompany intraoperative sentinel node identification.$96.13

How 38900 has changed in King County, WA

38900 · Office / nonfacility

$155.36

Effective 2026-10-01

The base rate is $14.49 higher than on 2025-10-01, moving from $140.87 to $155.36 (10.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $140.87changed to$155.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.50 changed to 2.44
    • Practice expense RVU 1.02 changed to 1.31
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $144.16changed to$140.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.00 changed to 1.02

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $141.81changed to$144.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $144.12changed to$141.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.98 changed to 1.00
    • Malpractice RVU 0.58 changed to 0.59
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $146.24changed to$144.12

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.60 changed to 0.58
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $146.34changed to$146.24

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.96 changed to 0.98
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $150.78changed to$146.34

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.93 changed to 0.96
    • Malpractice RVU 0.60 changed to 0.59
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $149.91changed to$150.78

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.91 changed to 0.93
    • Malpractice RVU 0.59 changed to 0.60
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $149.33changed to$149.91

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.90 changed to 0.91

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $145.00changed to$149.33

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.91 changed to 0.90
    • Malpractice RVU 0.60 changed to 0.59
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $140.01changed to$145.00

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $140.16changed to$140.01

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.58 changed to 0.60

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $139.47changed to$140.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $142.27changed to$139.47

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.92 changed to 0.91
    • Malpractice RVU 0.51 changed to 0.58
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $141.99changed to$142.27

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.00 changed to 0.92
    • Malpractice RVU 0.53 changed to 0.51
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $141.99

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$155.36$128.31RVU26D
2026-07-01$155.36$128.31RVU26C
2026-04-01$155.36$128.31RVU26B
2026-01-01$155.36$128.31RVU26A
2025-10-01$140.87$140.87RVU25D
2025-07-01$140.87$140.87RVU25C
2025-04-01$140.87$140.87RVU25B
2025-01-01$140.87$140.87RVU25A
2024-10-01$144.16$144.16RVU24D
2024-07-01$144.16$144.16RVU24C
2024-04-01$144.16$144.16RVU24B
2024-03-09$144.16$144.16RVU24AR
2024-01-01$141.81$141.81RVU24A
2023-10-01$144.12$144.12RVU23D
2023-07-01$144.12$144.12RVU23C
2023-04-01$144.12$144.12RVU23B
2023-01-01$144.12$144.12RVU23A
2022-10-01$146.24$146.24RVU22D
2022-07-01$146.24$146.24RVU22C
2022-04-01$146.24$146.24RVU22B
2022-01-01$146.24$146.24RVU22A
2021-10-01$146.34$146.34RVU21D
2021-07-01$146.34$146.34RVU21C
2021-04-01$146.34$146.34RVU21B
2021-01-01$146.34$146.34RVU21A
2020-10-01$150.78$150.78RVU20D
2020-07-01$150.78$150.78RVU20C
2020-04-01$150.78$150.78RVU20B
2020-01-01$150.78$150.78RVU20A
2019-10-01$149.91$149.91RVU19D
2019-07-01$149.91$149.91RVU19C
2019-04-01$149.91$149.91RVU19B
2019-01-01$149.91$149.91RVU19A
2018-10-01$149.33$149.33RVU18D
2018-07-01$149.33$149.33RVU18C
2018-04-01$149.33$149.33RVU18B
2018-01-01$149.33$149.33RVU18AR1
2017-10-01$145.00$145.00RVU17D
2017-07-01$145.00$145.00RVU17C
2017-04-01$145.00$145.00RVU17B
2017-01-01$145.00$145.00RVU17A
2016-10-01$140.01$140.01RVU16D
2016-07-01$140.01$140.01RVU16C
2016-04-01$140.01$140.01RVU16B
2016-01-01$140.01$140.01RVU16A
2015-10-01$140.16$140.16RVU15D
2015-07-01$140.16$140.16RVU15C
2015-04-01$139.47$139.47RVU15B
2015-01-01$139.47$139.47RVU15A
2014-10-01$142.27$142.27RVU14D
2014-07-01$142.27$142.27RVU14C
2014-04-01$142.27$142.27RVU14B
2014-01-01$142.27$142.27RVU14A
2013-10-01$141.99$141.99RVU13D
2013-07-01$141.99$141.99RVU13C
2013-04-01$141.99$141.99RVU13B
2013-01-01$141.99$141.99RVU13AR

Price 38900 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 38900 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

38900 billing questions

Is 38900 reported for each sentinel node removed?

Report it for the intraoperative mapping service, not once for every node identified or excised. The node removal is reported with the applicable primary procedure.

Can 38900 be billed by itself?

No. It is an add-on code and must be reported with a primary procedure, such as an open lymph node biopsy.

Is injection of blue dye separately reported with 38900?

The code includes injection of nonradioactive dye when performed. Document the mapping and dye use in the operative report.

How does 38900 differ from 38792?

38900 describes intraoperative identification of sentinel node(s). Code 38792 describes injection of radioactive tracer for sentinel node identification.

How is bilateral mapping reported?

When the procedure is bilateral and reported with modifier 50, CMS pays 150% of the applicable payment for 38900.

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 38900PPRRVU2026_Oct_nonQPP.csv, line 4,772 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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