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Billing code 39200: Mediastinal cystMedicare rate & RVUs

Surgical removal of a cyst in the mediastinum, reported when the operative service is definitive excision rather than tumor resection or diagnostic sampling.

CMS RVU26DEffective Oct 1, 2026109 payment localities38 Medicare services in 2024

Medicare pays $831.68 for 39200 nationally in a facility.

Medicare rate · 39200

Mediastinal cyst

Swap in your local Medicare rate.

Work RVUs
14.71
Total RVUs
24.90
Global days
090

National rate · 2026

$831.68

Facility setting, before claim adjustments.

See every locality for 39200 → · 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 39200 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 39200 covers

Code 39200 describes open surgical removal of a cyst located in the mediastinum, the central compartment of the chest between the lungs. A thoracic or cardiothoracic surgeon typically performs the operation in a hospital operating room. A bronchogenic cyst is one example; the operative record should establish that the lesion is cystic and mediastinal, rather than a solid tumor or a lesion in another chest compartment.

Report the code when the surgeon resects the cyst, not when the service is limited to diagnostic sampling. The operative report should document the lesion’s location, cystic nature, and the procedure performed. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require 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 39200 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

39200 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$750.95
Alaska*Unavailable$1,035.95
ArizonaUnavailable$807.17
ArkansasUnavailable$741.18
AtlantaUnavailable$861.46
AustinUnavailable$831.15
BakersfieldUnavailable$813.51
Baltimore/Surr. CntysUnavailable$884.66
BeaumontUnavailable$803.40
BrazoriaUnavailable$806.47

39200 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
39200 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 39200 rate is calculated

Each of 39200’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 · 39200

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.71Practice expense 6.49Malpractice 3.70

24.9000 adjusted RVUs×$33.4009 conversion factor=$831.68

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

Payment rules and modifiers for 39200

39200 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 39200

Mediastinal cyst

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 39200

Mediastinal cyst

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

39200 without 51 · national facility

$831.68

Mediastinal cyst

39200-51 · Second procedure: 50%

$415.84

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

39200 compared with similar codes

Compare codes

39200 vs 39220 vs 32662 vs 39401: national Medicare rates

Swap in your local Medicare rate.

  • 39200
    Mediastinal cyst · 14.71 wRVU
    —
  • 39220
    Mediastinal resection · 19.06 wRVU
    —
  • 32662
    Mediastinal excision · 14.62 wRVU
    —
  • 39401
    Mediastinoscopy · 5.3 wRVU
    —

How to choose

39220Mediastinal resection
Choose 39200 for resection of a mediastinal cyst and 39220 for resection of a mediastinal tumor.
32662Mediastinal excision
32662 describes thoracoscopic excision of a mediastinal cyst, tumor, or mass; 39200 is the open resection code.
39401Mediastinoscopy
39401 is mediastinoscopy with lymph-node biopsy for diagnostic sampling. It does not represent surgical removal of a mediastinal cyst.

Codes related to 39200

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

Codes related to 39200
CodeHow it relatesNational office range
Same family
39220Mediastinal resectionRelated open mediastinal resection code for a tumor rather than a cyst.No office rate
Used instead
32662Mediastinal excisionThoracoscopic removal of a mediastinal cyst, tumor, or mass uses a different operative approach.No office rate
39401MediastinoscopyMediastinoscopy with lymph-node biopsy is a diagnostic sampling service, not cyst removal.No office rate

39200 billing questions

How is this code distinguished from mediastinal tumor resection?

Use 39200 for resection of a mediastinal cyst. Code 39220 describes resection of a mediastinal tumor.

Can this code be used for a diagnostic biopsy?

No. This code represents surgical removal of the cyst; a service limited to diagnostic sampling is not cyst resection.

Should modifier 50 be appended for bilateral treatment?

No. The descriptor and anatomy make modifier 50 inappropriate for this code.

How does the multiple-procedure reduction affect payment?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.

What surgical-assistance billing rules apply?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and 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 39200PPRRVU2026_Oct_nonQPP.csv, line 4,776 (RVU26D)

Open CMS sourceHow we calculate rates

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