CPT 38505: Lymph node biopsyMedicare rate & RVUs

Percutaneous needle sampling of a superficial lymph node for tissue diagnosis, commonly used to evaluate palpable or imaging-detected cervical, axillary, or inguinal adenopathy.

CMS RVU26DEffective Oct 1, 2026109 payment localities36.6K Medicare services in 2024

Medicare pays $170.34 for 38505 nationally in the office and $74.82 in a hospital or facility. Local office rates run $151.67–$223.30.

Medicare rate · 38505

Lymph node biopsy

Swap in your local Medicare rate.

Work RVUs
1.55
Total RVUs
5.10
Global days
000

National rate · 2026

$170.34

Office setting, before claim adjustments.

See every locality for 38505 →

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

On this page 10 sections
  1. Medicare rate
  2. What 38505 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 38505 covers

Code 38505 describes needle sampling of a superficial lymph node to obtain tissue for diagnostic evaluation. It is commonly performed for enlarged or suspicious cervical, axillary, or inguinal nodes, including nodes identified on examination or imaging. Radiologists, surgeons, and other qualified physicians may perform the procedure in an office, imaging department, or facility setting. The needle technique distinguishes this service from open removal or biopsy of a node.

Report the code when the documented procedure involves needle biopsy of a superficial node; record the sampled site and the technique used. Same-day preoperative and postoperative care is included in its 0-day global period. 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. For bilateral service, modifier 50 results in payment at 150%. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are 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 38505 pays more and less

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

109 payment localities

$151.67 to $223.30

$151.67$187.49$223.30
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

38505 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$153.77$70.18
Alaska*$201.02$99.28
Arizona$166.03$73.46
Arkansas$151.67$69.62
Atlanta$173.45$76.39
Austin$176.35$75.28
Bakersfield$179.95$75.25
Baltimore/Surr. Cntys$180.76$78.26
Beaumont$159.78$72.85
Brazoria$168.49$73.83

38505 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$151.67

$201.37

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

View every state and territory as a table
38505 office rate range by state
State / territoryOffice rate rangeLocalities
AK$201.021
AL$153.771
AR$151.671
AZ$166.031
CA$179.43–$223.3029
CO$176.951
CT$181.271
DC$193.881
DE$168.681
FL$168.23–$183.663
GA$159.24–$173.452
GU$183.421
HI$183.421
IA$157.321
ID$158.321
IL$163.72–$178.624
IN$159.181
KS$156.691
KY$157.331
LA$157.12–$164.462
MA$176.00–$193.742
MD$171.75–$193.883
ME$159.17–$167.232
MI$161.26–$170.292
MN$169.621
MO$154.62–$164.943
MS$153.171
MT$170.331
NC$160.731
ND$166.971
NE$158.121
NH$174.261
NJ$183.35–$192.062
NM$162.121
NV$169.511
NY$163.01–$199.865
OH$160.571
OK$157.001
OR$168.21–$182.252
PA$160.77–$177.002
PR$171.501
RI$174.441
SC$160.911
SD$166.571
TN$157.441
TX$159.78–$176.358
UT$162.991
VA$166.76–$193.882
VI$171.501
VT$166.411
WA$175.64–$197.522
WI$161.671
WV$158.001
WY$168.871

How the 38505 rate is calculated

Each of 38505’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 · 38505

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.55Practice expense 3.38Malpractice 0.17

5.1000 adjusted RVUs×$33.4009 conversion factor=$170.34

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 38505

The CMS indicators that decide how 38505 is paid alongside other services.

CMS payment indicators · 38505

Lymph node biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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

38505 without 50 · national office

$170.34

Lymph node biopsy

38505-50 · Bilateral: 150%

$255.51

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

38505 compared with similar codes

Compare codes

38505 vs 38500 vs 38510 vs 10005: national Medicare rates

Swap in your local Medicare rate.

  • 38505
    Lymph node biopsy · 1.55 wRVU
    $170.34
  • 38500
    Lymph node biopsy · 3.7 wRVU
    $369.41+$199.07
  • 38510
    Lymph node biopsy · 6.57 wRVU
    $551.11+$380.77
  • 10005
    Ultrasound-guided FNA · 1.42 wRVU
    $132.27−$38.07

How to choose

38500Lymph node biopsy
Choose 38505 for needle sampling of a superficial node; choose 38500 when the node is biopsied or removed through an open approach.
38510Lymph node biopsy
38510 describes an open procedure on a deep cervical node. 38505 describes needle sampling of a superficial node.
10005Ultrasound-guided FNA
10005 is for fine needle aspiration with imaging guidance. 38505 is for needle biopsy of a superficial lymph node, rather than an aspiration service.

38505 billing questions

When should 38505 be used instead of 38500?

Use 38505 for needle sampling of a superficial lymph node. Code 38500 describes an open biopsy or removal of a superficial node.

How does 38505 differ from fine needle aspiration?

38505 represents needle biopsy of a superficial node, commonly performed to obtain tissue. Fine needle aspiration codes apply when the service is aspiration sampling, with code selection depending on whether imaging guidance is used.

Can modifier 50 be reported for bilateral node biopsies?

Yes. CMS identifies 38505 as bilateral, and modifier 50 results in payment at 150% when the procedure is performed bilaterally.

Does the code include same-day postoperative care?

Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be paid for 38505?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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
RVUs for 38505PPRRVU2026_Oct_nonQPP.csv, line 4,742 (RVU26D)

Open CMS sourceHow we calculate rates

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