$328.90–$501.73
Choose 38300 when the operation drains a lymph node lesion. Choose 38308 when the surgeon incises lymphatic channels themselves.
On this page
CMS RVU26D · Effective 2026-10-01
38308 Lymphatic surgery Medicare reimbursement rates
Reports an operative incision into lymphatic channels when the surgeon directly treats the channels rather than draining a lymph node lesion. Compare 38308 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 38308?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 38308 pays more and less
Lymphatic surgery
About 38308: Incision of lymphatic channels
Reports an operative incision into lymphatic channels when the surgeon directly treats the channels rather than draining a lymph node lesion.
A surgeon reports 38308 for an operation in which the lymphatic channels themselves are incised. The operative target is the lymphatic pathway, not a lymph node or a lesion within a lymph node. This is a facility-based surgical service; Medicare recorded facility services for the code in 2024 and no office services. The code is distinct from procedures directed at the thoracic duct, which have separate codes.
The operative report should identify the lymphatic channels treated and describe the incision performed, so the record distinguishes this work from lymph node drainage. This major procedure has a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and other procedures at half their value. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 38308
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.64 · 50%
- Practice expense (office) RVU5.25 · 39%
- Malpractice RVU1.51 · 11%
160
Medicare services in 2024 · #4511 by national volume
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.
38308 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
38305 is for drainage directed at a lymph node lesion; 38308 describes an incision directed at lymphatic channels.
No office rate
38380 is a thoracic duct procedure. Use 38308 when the operation is directed at lymphatic channels rather than specifically at the thoracic duct.
See how rates vary across the country
38308 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 38308 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $403.76 |
| Alaska* | Office Unavailable | Facility $547.22 |
| Arizona | Office Unavailable | Facility $434.87 |
| Arkansas | Office Unavailable | Facility $398.39 |
| Atlanta | Office Unavailable | Facility $461.18 |
| Austin | Office Unavailable | Facility $452.44 |
| Bakersfield | Office Unavailable | Facility $448.90 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $475.87 |
| Beaumont | Office Unavailable | Facility $428.21 |
| Brazoria | Office Unavailable | Facility $436.67 |
| Chicago | Office Unavailable | Facility $515.32 |
| Chico | Office Unavailable | Facility $444.77 |
| Colorado | Office Unavailable | Facility $450.41 |
| Connecticut | Office Unavailable | Facility $476.10 |
| Dallas | Office Unavailable | Facility $441.70 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $496.46 |
| Delaware | Office Unavailable | Facility $441.48 |
| Detroit | Office Unavailable | Facility $476.03 |
| East St. Louis | Office Unavailable | Facility $484.69 |
| El Centro | Office Unavailable | Facility $445.03 |
| Fort Lauderdale | Office Unavailable | Facility $490.60 |
| Fort Worth | Office Unavailable | Facility $440.61 |
| Fresno | Office Unavailable | Facility $444.77 |
| Galveston | Office Unavailable | Facility $439.44 |
| Hanford-Corcoran | Office Unavailable | Facility $444.77 |
| Hawaii, Guam | Office Unavailable | Facility $450.36 |
| Houston | Office Unavailable | Facility $467.08 |
| Idaho | Office Unavailable | Facility $406.96 |
| Indiana | Office Unavailable | Facility $408.85 |
| Iowa | Office Unavailable | Facility $402.25 |
| Kansas | Office Unavailable | Facility $405.72 |
| Kentucky | Office Unavailable | Facility $423.82 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $471.81 |
| Madera | Office Unavailable | Facility $444.77 |
| Manhattan | Office Unavailable | Facility $519.73 |
| Merced | Office Unavailable | Facility $444.77 |
| Metropolitan Boston | Office Unavailable | Facility $485.14 |
| Metropolitan Kansas City | Office Unavailable | Facility $435.72 |
| Metropolitan Philadelphia | Office Unavailable | Facility $468.49 |
| Metropolitan St. Louis | Office Unavailable | Facility $439.26 |
| Miami | Office Unavailable | Facility $531.88 |
| Minnesota | Office Unavailable | Facility $417.15 |
| Mississippi | Office Unavailable | Facility $410.03 |
| Modesto | Office Unavailable | Facility $444.77 |
| Montana** | Office Unavailable | Facility $447.47 |
| Napa | Office Unavailable | Facility $492.49 |
| Nebraska | Office Unavailable | Facility $402.70 |
| Nevada** | Office Unavailable | Facility $439.32 |
| New Hampshire | Office Unavailable | Facility $448.46 |
| New Mexico | Office Unavailable | Facility $443.16 |
| New Orleans | Office Unavailable | Facility $444.09 |
| North Carolina | Office Unavailable | Facility $417.62 |
| North Dakota** | Office Unavailable | Facility $417.61 |
| Northern Nj | Office Unavailable | Facility $493.03 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $538.13 |
| Ohio | Office Unavailable | Facility $432.72 |
| Oklahoma | Office Unavailable | Facility $417.56 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $466.68 |
| Portland | Office Unavailable | Facility $457.67 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $484.80 |
| Puerto Rico | Office Unavailable | Facility $448.74 |
| Queens | Office Unavailable | Facility $515.97 |
| Redding | Office Unavailable | Facility $444.77 |
| Rest Of California | Office Unavailable | Facility $444.77 |
| Rest Of Florida | Office Unavailable | Facility $465.23 |
| Rest Of Georgia | Office Unavailable | Facility $438.32 |
| Rest Of Illinois | Office Unavailable | Facility $460.71 |
| Rest Of Louisiana | Office Unavailable | Facility $425.29 |
| Rest Of Maine | Office Unavailable | Facility $414.48 |
| Rest Of Maryland | Office Unavailable | Facility $447.76 |
| Rest Of Massachusetts | Office Unavailable | Facility $450.18 |
| Rest Of Michigan | Office Unavailable | Facility $438.82 |
| Rest Of Missouri | Office Unavailable | Facility $422.06 |
| Rest Of New Jersey | Office Unavailable | Facility $477.47 |
| Rest Of New York | Office Unavailable | Facility $423.83 |
| Rest Of Oregon | Office Unavailable | Facility $431.89 |
| Rest Of Pennsylvania | Office Unavailable | Facility $430.42 |
| Rest Of Texas | Office Unavailable | Facility $433.74 |
| Rest Of Washington | Office Unavailable | Facility $447.69 |
| Rhode Island | Office Unavailable | Facility $452.13 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $460.98 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $460.74 |
| Salinas | Office Unavailable | Facility $458.93 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $465.50 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $513.25 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $511.54 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $526.07 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $519.06 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $452.31 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $466.53 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $459.49 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $470.80 |
| Seattle (King Cnty) | Office Unavailable | Facility $489.24 |
| South Carolina | Office Unavailable | Facility $426.68 |
| South Dakota** | Office Unavailable | Facility $414.08 |
| Southern Maine | Office Unavailable | Facility $427.38 |
| Stockton | Office Unavailable | Facility $444.77 |
| Suburban Chicago | Office Unavailable | Facility $492.80 |
| Tennessee | Office Unavailable | Facility $408.26 |
| Utah | Office Unavailable | Facility $431.91 |
| Vallejo | Office Unavailable | Facility $490.02 |
| Vermont | Office Unavailable | Facility $420.90 |
| Virgin Islands | Office Unavailable | Facility $448.74 |
| Virginia | Office Unavailable | Facility $429.76 |
| Visalia | Office Unavailable | Facility $444.77 |
| West Virginia | Office Unavailable | Facility $446.34 |
| Wisconsin | Office Unavailable | Facility $405.31 |
| Wyoming** | Office Unavailable | Facility $434.46 |
| Yuba City | Office Unavailable | Facility $444.77 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
38308 billing questions
How is 38308 different from lymph node drainage?
38308 is for an incision directed at lymphatic channels. Use a lymph node drainage code when the operative target is a lesion in a lymph node.
What documentation supports 38308?
The operative report should identify the lymphatic channels treated and describe the incision. This helps distinguish the service from drainage of a lymph node lesion or a thoracic duct procedure.
Are the preoperative visit and postoperative visits separately included?
The day-before preoperative visit and related postoperative care during the 90-day global period are included in the surgical payment.
Can 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.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are paid at half their value under the standard multiple procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,73438243,,Transplj hematopoietic boost,A,,2.08,0.82,NA,0.82,,0.14,3.04,3.04,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73538300,,Drainage lymph node lesion,A,,2.30,8.42,,3.56,,0.61,11.33,6.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73638305,,Drainage lymph node lesion,A,,6.51,6.46,NA,6.46,,1.74,14.71,14.71,0,090,0.11,0.73,0.16,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73738308,,Incision of lymph channels,A,,6.64,5.25,NA,5.25,,1.51,13.40,13.40,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73838380,,Thoracic duct procedure,A,,8.25,5.94,NA,5.94,,1.33,15.52,15.52,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73938381,,Thoracic duct procedure,A,,13.05,6.84,NA,6.84,,3.21,23.10,23.10,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74038382,,Thoracic duct procedure,A,,10.38,7.16,NA,7.16,,2.61,20.15,20.15,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00