Billing code 38510: Lymph node biopsyMedicare rate & RVUs
Reports open biopsy or excision of deep cervical lymph nodes when a surgeon obtains nodal tissue for diagnosis, such as evaluating suspected lymphoma or metastatic disease.
Medicare pays $551.11 for 38510 nationally in the office and $378.10 in a hospital or facility. Local office rates run $489.76–$683.42.
Medicare rate · 38510
Lymph node biopsy
Swap in your local Medicare rate.
- Work RVUs
- 6.57
- Total RVUs
- 16.50
- Global days
- 010
National rate · 2026
$551.11
Office setting, before claim adjustments.
See every locality for 38510 → · Billed by an NP, PA or therapist? →
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
What 38510 covers
This code covers an open surgical biopsy or removal of one or more deep cervical lymph nodes, commonly from the deep neck chain. An otolaryngologist, head and neck surgeon, or general surgeon may perform it when imaging or examination identifies a node requiring tissue diagnosis, including workup for suspected lymphoma or metastatic cancer. The node is submitted for pathologic examination; this is different from sampling a superficial neck node or using a needle approach.
Report the code for the open deep cervical procedure, documenting the node’s location, the operative approach, and whether biopsy or excision was performed. The 10-day global period includes related postoperative visits during that period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. For bilateral work, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 38510 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
$489.76 to $683.42
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $496.55 | $345.16 |
| Alaska* | $660.59 | $476.33 |
| Arizona | $536.04 | $368.39 |
| Arkansas | $489.76 | $341.14 |
| Atlanta | $564.93 | $389.14 |
| Austin | $563.49 | $380.44 |
| Bakersfield | $566.47 | $376.84 |
| Baltimore/Surr. Cntys | $585.79 | $400.15 |
| Beaumont | $522.07 | $364.63 |
| Brazoria | $540.93 | $369.48 |
| Chicago | $609.03 | $435.15 |
| Chico | $562.93 | $373.30 |
| Colorado | $562.97 | $378.88 |
| Connecticut | $586.68 | $400.35 |
| Dallas | $545.91 | $373.58 |
| Dc + Md/Va Suburbs | $619.25 | $415.43 |
| Delaware | $544.46 | $373.52 |
| Detroit | $570.09 | $403.13 |
| East St. Louis | $570.99 | $411.81 |
| El Centro | $563.14 | $373.52 |
| Fort Lauderdale | $589.15 | $413.88 |
| Fort Worth | $543.57 | $372.97 |
| Fresno | $562.93 | $373.30 |
| Galveston | $543.55 | $371.74 |
| Hanford-Corcoran | $562.93 | $373.30 |
| Hawaii, Guam | $572.88 | $376.16 |
| Houston | $566.80 | $394.99 |
| Idaho | $505.62 | $346.44 |
| Indiana | $508.20 | $347.81 |
| Iowa | $500.95 | $342.64 |
| Kansas | $502.31 | $345.90 |
| Kentucky | $515.40 | $361.59 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $598.79 | $394.11 |
| Madera | $562.93 | $373.30 |
| Manhattan | $636.88 | $435.83 |
| Merced | $562.93 | $373.30 |
| Metropolitan Boston | $611.56 | $404.98 |
| Metropolitan Kansas City | $532.49 | $370.03 |
| Metropolitan Philadelphia | $575.11 | $395.00 |
| Metropolitan St. Louis | $537.32 | $372.60 |
| Miami | $627.83 | $447.72 |
| Minnesota | $529.64 | $351.61 |
| Mississippi | $499.84 | $350.87 |
| Modesto | $562.93 | $373.30 |
| Montana** | $551.03 | $378.01 |
| Napa | $636.05 | $408.02 |
| Nebraska | $502.46 | $342.76 |
| Nevada** | $544.32 | $371.13 |
| New Hampshire | $557.67 | $377.56 |
| New Mexico | $535.63 | $376.98 |
| New Orleans | $539.82 | $377.01 |
| North Carolina | $516.42 | $355.00 |
| North Dakota** | $525.92 | $352.90 |
| Northern Nj | $614.10 | $413.41 |
| Nyc Suburbs/Long Island | $656.18 | $450.46 |
| Ohio | $526.29 | $368.33 |
| Oklahoma | $510.71 | $356.20 |
| Oxnard-Thousand Oaks-Ventura | $593.91 | $389.41 |
| Portland | $575.87 | $383.65 |
| Poughkpsie/N Nyc Suburbs | $597.38 | $407.92 |
| Puerto Rico | $553.66 | $378.74 |
| Queens | $636.55 | $432.05 |
| Redding | $562.93 | $373.30 |
| Rest Of California | $562.93 | $373.30 |
| Rest Of Florida | $559.72 | $394.32 |
| Rest Of Georgia | $528.02 | $373.69 |
| Rest Of Illinois | $549.83 | $391.87 |
| Rest Of Louisiana | $516.07 | $362.95 |
| Rest Of Maine | $511.94 | $352.76 |
| Rest Of Maryland | $553.30 | $378.21 |
| Rest Of Massachusetts | $561.35 | $379.16 |
| Rest Of Michigan | $531.42 | $373.46 |
| Rest Of Missouri | $510.10 | $360.95 |
| Rest Of New Jersey | $590.62 | $401.68 |
| Rest Of New York | $524.05 | $359.69 |
| Rest Of Oregon | $537.36 | $365.03 |
| Rest Of Pennsylvania | $525.06 | $366.23 |
| Rest Of Texas | $532.25 | $368.06 |
| Rest Of Washington | $559.16 | $376.97 |
| Rhode Island | $560.25 | $381.52 |
| Riverside-San Bernardino-Ontario | $576.60 | $386.97 |
| Sacramento-Roseville-Folsom | $586.48 | $385.26 |
| Salinas | $584.23 | $383.70 |
| San Diego-Chula Vista-Carlsbad | $594.96 | $388.04 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $667.61 | $423.65 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $666.16 | $422.21 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $683.42 | $433.93 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $677.52 | $428.03 |
| San Luis Obispo-Paso Robles | $575.37 | $378.30 |
| Santa Cruz-Watsonville | $598.23 | $388.01 |
| Santa Maria-Santa Barbara | $585.59 | $383.86 |
| Santa Rosa-Petaluma | $603.97 | $391.50 |
| Seattle (King Cnty) | $619.98 | $407.69 |
| South Carolina | $522.77 | $362.90 |
| South Dakota** | $522.95 | $349.93 |
| Southern Maine | $532.86 | $361.40 |
| Stockton | $562.93 | $373.30 |
| Suburban Chicago | $593.21 | $415.52 |
| Tennessee | $505.15 | $347.88 |
| Utah | $529.43 | $366.80 |
| Vallejo | $633.97 | $405.94 |
| Vermont | $527.27 | $355.98 |
| Virgin Islands | $553.66 | $378.74 |
| Virginia | $533.73 | $363.65 |
| Visalia | $562.93 | $373.30 |
| West Virginia | $531.51 | $381.15 |
| Wisconsin | $509.61 | $343.86 |
| Wyoming** | $540.09 | $367.07 |
| Yuba City | $562.93 | $373.30 |
38510 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$489.76
$660.59
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $660.59 | 1 |
| AL | $496.55 | 1 |
| AR | $489.76 | 1 |
| AZ | $536.04 | 1 |
| CA | $562.93–$683.42 | 29 |
| CO | $562.97 | 1 |
| CT | $586.68 | 1 |
| DC | $619.25 | 1 |
| DE | $544.46 | 1 |
| FL | $559.72–$627.83 | 3 |
| GA | $528.02–$564.93 | 2 |
| GU | $572.88 | 1 |
| HI | $572.88 | 1 |
| IA | $500.95 | 1 |
| ID | $505.62 | 1 |
| IL | $549.83–$609.03 | 4 |
| IN | $508.20 | 1 |
| KS | $502.31 | 1 |
| KY | $515.40 | 1 |
| LA | $516.07–$539.82 | 2 |
| MA | $561.35–$611.56 | 2 |
| MD | $553.30–$619.25 | 3 |
| ME | $511.94–$532.86 | 2 |
| MI | $531.42–$570.09 | 2 |
| MN | $529.64 | 1 |
| MO | $510.10–$537.32 | 3 |
| MS | $499.84 | 1 |
| MT | $551.03 | 1 |
| NC | $516.42 | 1 |
| ND | $525.92 | 1 |
| NE | $502.46 | 1 |
| NH | $557.67 | 1 |
| NJ | $590.62–$614.10 | 2 |
| NM | $535.63 | 1 |
| NV | $544.32 | 1 |
| NY | $524.05–$656.18 | 5 |
| OH | $526.29 | 1 |
| OK | $510.71 | 1 |
| OR | $537.36–$575.87 | 2 |
| PA | $525.06–$575.11 | 2 |
| PR | $553.66 | 1 |
| RI | $560.25 | 1 |
| SC | $522.77 | 1 |
| SD | $522.95 | 1 |
| TN | $505.15 | 1 |
| TX | $522.07–$566.80 | 8 |
| UT | $529.43 | 1 |
| VA | $533.73–$619.25 | 2 |
| VI | $553.66 | 1 |
| VT | $527.27 | 1 |
| WA | $559.16–$619.98 | 2 |
| WI | $509.61 | 1 |
| WV | $531.51 | 1 |
| WY | $540.09 | 1 |
How the 38510 rate is calculated
Each of 38510’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 · 38510
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.57Practice expense 8.66Malpractice 1.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 38510
38510 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 38510
Lymph node biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 38510
Lymph node biopsy
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
38510 without 50 · national office
$551.11
Lymph node biopsy
38510-50 · Bilateral: 150%
$826.67
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).
38510 compared with similar codes
Compare codes
38510 vs 38500 vs 38505 vs 38520 vs 38525: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 38500Lymph node biopsy
- Choose 38510 for open sampling or removal of deep cervical nodes; 38500 is for superficial lymph nodes.
- 38505Lymph node biopsy
- Choose 38505 for percutaneous needle sampling. The open surgical approach to a deep cervical node is reported with 38510.
- 38520Lymph node biopsy
- 38520 includes the scalene fat pad with open deep cervical node work. Use 38510 when that tissue is not included.
- 38525Axillary node biopsy
- Both describe open nodal procedures, but 38525 is for deep axillary nodes; 38510 is for deep cervical nodes.
38510 billing questions
How does this differ from 38500?
38510 is for open work on deep cervical nodes. Code 38500 applies to open biopsy or excision of superficial lymph nodes.
Can 38510 be used for a needle biopsy?
No. For percutaneous needle sampling of a lymph node, consider 38505; 38510 describes an open surgical approach to deep cervical nodes.
When is 38520 more appropriate?
38520 describes open deep cervical node work that includes the scalene fat pad. Use 38510 when that additional tissue is not part of the procedure.
How is bilateral deep cervical work reported?
The CMS payment rule identifies modifier 50 for bilateral procedures and pays the procedure at 150%. Document the work on both sides.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure’s payment.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 38510. Co-surgeons and team surgery are not permitted under the listed CMS rules.
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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