FeeBase
Log inGet started
Menu

Billing code 38550: Hygroma excisionMedicare rate & RVUs

Reports surgical removal of a cystic hygroma in the neck or armpit, such as a congenital lymphatic malformation requiring operative excision.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $517.71 for 38550 nationally in a facility.

Medicare rate · 38550

Hygroma excision

Swap in your local Medicare rate.

Work RVUs
6.93
Total RVUs
15.50
Global days
090

National rate · 2026

$517.71

Facility setting, before claim adjustments.

See every locality for 38550 → · 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
  1. Medicare rate
  2. What 38550 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 38550 covers

This code describes surgical excision of a cystic hygroma, a lymphatic malformation, in the cervical or axillary region. A surgeon may perform the operation in a hospital or ambulatory surgical setting, often for a congenital lesion that is enlarging, symptomatic, or affecting nearby structures. The target is the malformation itself, not a lymph node removed for diagnostic sampling or nodal dissection.

Report the code when the operative record supports excision of a cervical or axillary cystic hygroma and identifies the site and extent of removal. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that 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% multiple-procedure reduction. Modifier 50 is inappropriate under the CMS bilateral rule for this code. Assistant-at-surgery payment requires documented medical necessity; 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 38550 pays more and less

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

109 of 109 payment localities

38550 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$462.84
Alaska*Unavailable$620.29
ArizonaUnavailable$501.86
ArkansasUnavailable$456.10
AtlantaUnavailable$534.42
AustinUnavailable$524.15
BakersfieldUnavailable$519.50
Baltimore/Surr. CntysUnavailable$552.45
BeaumontUnavailable$493.13
BrazoriaUnavailable$503.95

38550 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.

View every state and territory as a table
38550 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 38550 rate is calculated

Each of 38550’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 · 38550

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.93Practice expense 6.72Malpractice 1.85

15.5000 adjusted RVUs×$33.4009 conversion factor=$517.71

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

Payment rules and modifiers for 38550

38550 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38550

Hygroma excision

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 38550

Hygroma excision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

38550 without 51 · national facility

$517.71

Hygroma excision

38550-51 · Second procedure: 50%

$258.86

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

38550 compared with similar codes

Compare codes

38550 vs 38555 vs 38520 vs 38500: national Medicare rates

Swap in your local Medicare rate.

  • 38550
    Hygroma excision · 6.93 wRVU
    —
  • 38555
    Lesion excision · 15.2 wRVU
    —
  • 38520
    Lymph node biopsy · 6.85 wRVU
    —
  • 38500
    Lymph node biopsy · 3.7 wRVU
    $369.41

How to choose

38555Lesion excision
Both codes concern cystic hygroma excision, but 38555 is for the mediastinum; this code is for the cervical or axillary region.
38520Lymph node biopsy
38520 describes excision of deep cervical lymph nodes. Choose this code only when the operative target is nodal tissue rather than a cystic hygroma.
38500Lymph node biopsy
38500 is for biopsy or excision of superficial lymph nodes. It does not describe removal of a cervical or axillary cystic hygroma.

Codes related to 38550

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

Codes related to 38550
CodeHow it relatesNational office range
Same family
38555Lesion excisionExcision code for a cystic hygroma at the mediastinal site.No office rate

38550 billing questions

How does this differ from lymph node excision codes?

Use this code for excision of a cervical or axillary cystic hygroma. Codes such as 38500 or 38520 describe lymph node procedures, not removal of a lymphatic malformation.

When would 38555 be reported instead?

38555 is for excision of a mediastinal cystic hygroma. This code is for a cervical or axillary site.

Can modifier 50 be appended for lesions on both sides?

CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.

What documentation supports reporting this code?

The operative report should identify the lesion as a cystic hygroma, document its cervical or axillary location, and describe the excision performed.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted under the CMS rules for this code.

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 38550PPRRVU2026_Oct_nonQPP.csv, line 4,749 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 38550 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 38550 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →