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Billing code 38745: Axillary dissectionMedicare rate & RVUs

Report this service for a complete axillary lymph node dissection, typically performed to treat or stage breast cancer when broader nodal removal is required.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.4K Medicare services in 2024

Medicare pays $840.03 for 38745 nationally in a facility.

Medicare rate · 38745

Axillary dissection

Swap in your local Medicare rate.

Work RVUs
13.52
Total RVUs
25.15
Global days
090

National rate · 2026

$840.03

Facility setting, before claim adjustments.

See every locality for 38745 → · 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 38745 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 38745 covers

A surgeon removes a broad group of lymph nodes from the armpit, most often during breast cancer treatment or staging when the operative plan calls for a complete axillary dissection rather than limited node sampling. The service is generally performed in an operating room by a surgeon, often alongside breast surgery. The operative report should identify the axillary dissection and its extent; a few nodes removed for biopsy or sentinel-node evaluation are not the same service.

Select this code for the complete dissection, not the more limited axillary procedure represented by 38740. When a breast procedure code already includes axillary lymphadenectomy, do not separately report the same dissection. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are reduced. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 38745 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

38745 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$756.28
Alaska*Unavailable$1,032.53
ArizonaUnavailable$815.12
ArkansasUnavailable$746.08
AtlantaUnavailable$868.67
AustinUnavailable$843.88
BakersfieldUnavailable$830.44
Baltimore/Surr. CntysUnavailable$894.29
BeaumontUnavailable$807.24
BrazoriaUnavailable$816.12

38745 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.

View every state and territory as a table
38745 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 38745 rate is calculated

Each of 38745’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 · 38745

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.52Practice expense 8.22Malpractice 3.41

25.1500 adjusted RVUs×$33.4009 conversion factor=$840.03

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

Payment rules and modifiers for 38745

38745 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38745

Axillary dissection

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)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.
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 · 38745

Axillary dissection

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 50 · payment effect

With and without the modifier

38745 without 50 · national facility

$840.03

Axillary dissection

38745-50 · Bilateral: 150%

$1,260.05

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

38745 compared with similar codes

Compare codes

38745 vs 38740 vs 38525 vs 19302 vs 19307: national Medicare rates

Swap in your local Medicare rate.

  • 38745
    Axillary dissection · 13.52 wRVU
    —
  • 38740
    Axillary dissection · 10.43 wRVU
    —
  • 38525
    Axillary node biopsy · 6.27 wRVU
    —
  • 19302
    Partial mastectomy · 13.64 wRVU
    —
  • 19307
    Mastectomy · 17.54 wRVU
    —

How to choose

38740Axillary dissection
Choose 38745 for a complete axillary dissection; 38740 describes a more limited dissection.
38525Axillary node biopsy
38525 is for excision or biopsy of deep axillary nodes, not removal of the broader axillary nodal basin.
19302Partial mastectomy
19302 includes partial mastectomy with axillary lymphadenectomy. Do not separately report 38745 for the same included dissection.
19307Mastectomy
19307 describes a modified radical mastectomy that includes axillary node removal; 38745 is the separate axillary dissection service.

Codes related to 38745

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

Codes related to 38745
CodeHow it relatesNational office range
Same family
38740Axillary dissectionMore limited axillary lymphadenectomy in the same anatomic area.No office rate
Used instead
38525Axillary node biopsyDeep axillary node sampling or excision instead of complete basin dissection.No office rate
19302Partial mastectomyCombines partial mastectomy and axillary lymphadenectomy when both are performed.No office rate
Often billed with
38792Sentinel node injectionRadioactive tracer injection for sentinel-node identification may accompany same-session nodal surgery.$72.74–$109.38

38745 billing questions

How does this differ from 38740?

38745 represents a complete axillary dissection. Use 38740 for the more limited axillary lymphadenectomy.

Can this be reported with a breast operation?

It may be performed during breast cancer surgery, but do not separately report the dissection when the breast procedure code already includes axillary lymphadenectomy. For example, 19302 includes partial mastectomy with axillary lymphadenectomy.

Can I report this for a few removed nodes?

No. A limited biopsy or excision of deep axillary nodes is distinct from a complete dissection; 38525 may describe deep-node sampling instead.

How is bilateral surgery reported?

Use modifier 50 for bilateral performance. CMS pays the bilateral procedure at 150%.

What documentation supports 38745?

The operative report should establish that the surgeon performed a complete axillary dissection, rather than limited node sampling, and identify the side or sides treated.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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 38745PPRRVU2026_Oct_nonQPP.csv, line 4,762 (RVU26D)

Open CMS sourceHow we calculate rates

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