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Billing code 38790: Lymphangiography injectionMedicare rate & RVUs

Reports contrast injection into lymphatic channels to prepare for lymphangiography, commonly through peripheral lymphatic access for evaluation of abnormal lymphatic drainage.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.2K Medicare services in 2024

Medicare pays $75.82 for 38790 nationally in a facility.

Medicare rate · 38790

Lymphangiography injection

Swap in your local Medicare rate.

Work RVUs
1.26
Total RVUs
2.27
Global days
000

National rate · 2026

$75.82

Facility setting, before claim adjustments.

See every locality for 38790 → · 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 38790 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 38790 covers

This service covers placing contrast into the lymphatic system so the channels can be visualized during lymphangiography. A common approach is access to lymphatic vessels in the foot; an interventional radiologist or surgeon may perform the injection as part of imaging for suspected lymphatic obstruction or abnormal drainage. The injection procedure is distinct from the radiologic imaging and interpretation service.

Report the procedure when the clinician documents lymphatic access and contrast injection, including the access site and laterality. Pair it with the appropriate lymphangiography imaging code when that imaging service is performed and reported. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 38790 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

38790 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$69.54
Alaska*Unavailable$95.62
ArizonaUnavailable$74.02
ArkansasUnavailable$68.77
AtlantaUnavailable$77.72
AustinUnavailable$76.71
BakersfieldUnavailable$76.60
Baltimore/Surr. CntysUnavailable$80.05
BeaumontUnavailable$72.91
BrazoriaUnavailable$74.44

38790 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
38790 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 38790 rate is calculated

Each of 38790’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 · 38790

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.26Practice expense 0.81Malpractice 0.20

2.2700 adjusted RVUs×$33.4009 conversion factor=$75.82

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

Payment rules and modifiers for 38790

The CMS indicators that decide how 38790 is paid alongside other services.

CMS payment indicators · 38790

Lymphangiography injection

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

38790 without 50 · national facility

$75.82

Lymphangiography injection

38790-50 · Bilateral: 150%

$113.73

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

38790 compared with similar codes

Compare codes

38790 vs 38792 vs 38794 vs 75801: national Medicare rates

Swap in your local Medicare rate.

  • 38790
    Lymphangiography injection · 1.26 wRVU
    —
  • 38792
    Sentinel node injection · 0.63 wRVU
    $82.17
  • 38794
    Thoracic duct access · 4.5 wRVU
    —
  • 75801
    · 0 wRVU
    —

How to choose

38792Sentinel node injection
Use 38790 for contrast injection to visualize lymphatic channels. Use 38792 for injection used to identify a sentinel lymph node.
38794Thoracic duct access
This code describes lymphangiography injection through lymphatic access; 38794 concerns access to the thoracic duct for lymphangiography.
75801Lymph vessel x-ray arm/leg
This code represents the injection procedure. Code 75801 represents radiologic supervision and interpretation for extremity lymphangiography.

Codes related to 38790

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

Codes related to 38790
CodeHow it relatesNational office range
Often billed with
75801Lymph vessel x-ray arm/legRadiologic lymphangiography imaging of an extremity may accompany the injection when performed and reported.No office rate
75803Lymph vessel x-ray arms/legsRadiologic pelvic lymphangiography may accompany the injection when that region is imaged.No office rate
Used instead
38794Thoracic duct accessThoracic duct access is a distinct route for lymphangiography rather than peripheral lymphatic access.No office rate

38790 billing questions

How is this different from 38792?

This code represents contrast injection for lymphangiography. Code 38792 concerns injection for sentinel node identification, such as mapping a node for a biopsy or cancer operation.

Can lymphangiography imaging be reported separately?

The injection and the radiologic imaging service are distinct. When imaging is performed and reported, use the appropriate lymphangiography imaging code for the region examined.

When is modifier 50 appropriate?

CMS identifies this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%. Documentation should support injection on both sides.

What documentation supports the injection?

Record the clinical purpose, lymphatic access site and side, contrast injection, and the imaging performed. The documentation should distinguish lymphatic contrast injection from sentinel-node tracer or dye injection.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Same-day preoperative and postoperative care is included in this code's 0-day global period.

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 38790PPRRVU2026_Oct_nonQPP.csv, line 4,769 (RVU26D)

Open CMS sourceHow we calculate rates

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