Billing code 38780: Abdominal node dissectionMedicare rate & RVUs

Medicare pays $978.98 for 38780 nationally in a facility.

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

What 38780 covers

Code 38780 represents an extensive transabdominal operation to remove lymphatic tissue across the retroperitoneum, reaching pelvic, aortic, and renal nodal fields rather than a limited regional basin. Urologists and surgical oncologists commonly perform it for selected cancers requiring broad retroperitoneal clearance, including testicular malignancy; the operative report should establish the extent and nodal territories treated.

Report 38780 when the surgeon performs that extensive dissection, not for isolated sampling or a more confined pelvic or abdominal nodal clearance. Document the indication, approach, and nodal boundaries, and distinguish the work from other procedures performed in the same session. Medicare treats it as major surgery: the day-before preoperative visit and related care through 90 days after surgery are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures receive the standard reduction. Modifier 50 is inappropriate. An assistant may be paid; co-surgeons require supporting documentation, while 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 38780 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

38780 rates by state

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

How the 38780 rate is calculated

Each of 38780’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.

Payment rules and modifiers for 38780

38780 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

38780 compared with similar codes

How to choose

38747Abdominal lymphadenectomy

Choose 38747 for regional abdominal nodal clearance. Use 38780 when the operation involves extensive retroperitoneal dissection across pelvic, aortic, and renal fields.

38770Pelvic lymphadenectomy

38770 is directed to pelvic nodal groups. It does not describe the broader retroperitoneal dissection represented by 38780.

38746Lymph node dissection

38746 covers regional thoracic nodal dissection, such as mediastinal or periesophageal fields; 38780 is for extensive abdominal retroperitoneal fields.

Codes related to 38780

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

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

Open CMS sourceHow we calculate rates