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Billing code 39401: MediastinoscopyMedicare rate & RVUs

Report mediastinoscopy with biopsy when a surgeon uses a mediastinoscope to sample a mediastinal mass or tissue rather than mediastinal lymph nodes.

CMS RVU26DEffective Oct 1, 2026109 payment localities177 Medicare services in 2024

Medicare pays $292.59 for 39401 nationally in a facility.

Medicare rate · 39401

Mediastinoscopy

Swap in your local Medicare rate.

Work RVUs
5.3
Total RVUs
8.76
Global days
000

National rate · 2026

$292.59

Facility setting, before claim adjustments.

See every locality for 39401 → · 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 39401 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 39401 covers

A thoracic surgeon typically performs this procedure in an operating room, advancing a mediastinoscope through an incision at the base of the neck to reach and biopsy a mediastinal mass or other mediastinal tissue. The approach provides access to tissue behind the sternum for diagnostic evaluation, including in patients being assessed for a mediastinal lesion. The biopsy is part of the reported service.

Choose this code for mediastinal tissue or mass biopsy; use the lymph-node biopsy code when the sampled targets are mediastinal lymph nodes. The operative report should identify the mediastinal target and document the scope-guided biopsy. The 0-day global period includes same-day preoperative and postoperative care. 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% reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and 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 39401 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

39401 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$264.52
Alaska*Unavailable$365.95
ArizonaUnavailable$284.03
ArkansasUnavailable$261.13
AtlantaUnavailable$303.13
AustinUnavailable$292.07
BakersfieldUnavailable$285.58
Baltimore/Surr. CntysUnavailable$311.09
BeaumontUnavailable$283.03
BrazoriaUnavailable$283.67

39401 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
39401 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 39401 rate is calculated

Each of 39401’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 · 39401

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.30Practice expense 2.14Malpractice 1.32

8.7600 adjusted RVUs×$33.4009 conversion factor=$292.59

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

Payment rules and modifiers for 39401

The CMS indicators that decide how 39401 is paid alongside other services.

CMS payment indicators · 39401

Mediastinoscopy

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)0The 150% bilateral adjustment doesn’t apply.
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 51 · payment effect

With and without the modifier

39401 without 51 · national facility

$292.59

Mediastinoscopy

39401-51 · Second procedure: 50%

$146.30

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

39401 compared with similar codes

Compare codes

39401 vs 39402 vs 32606 vs 39499: national Medicare rates

Swap in your local Medicare rate.

  • 39401
    Mediastinoscopy · 5.3 wRVU
    —
  • 39402
    Mediastinoscopy · 7.07 wRVU
    —
  • 32606
    Thoracoscopy biopsy · 8.18 wRVU
    —
  • 39499
    · 0 wRVU
    —

How to choose

39402Mediastinoscopy
The target determines the choice: 39401 is for mediastinal mass or tissue biopsy, while 39402 is for mediastinal lymph-node biopsy.
32606Thoracoscopy biopsy
Both can involve mediastinal biopsy, but 32606 describes a thoracoscopic diagnostic approach; 39401 describes mediastinoscopy.
39499Unlisted px mediastinum
Use 39499 only when the mediastinal procedure performed is not represented by a specific listed code such as 39401.

Codes related to 39401

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

Codes related to 39401
CodeHow it relatesNational office range
Same family
39402MediastinoscopyMediastinoscopy with biopsy of mediastinal lymph nodes.No office rate
Used instead
32606Thoracoscopy biopsyThoracoscopic approach for diagnostic mediastinal biopsy.No office rate
39499Unlisted px mediastinumUnlisted mediastinal procedure when no specific code describes the service.No office rate

39401 billing questions

When should 39401 be chosen instead of 39402?

Use 39401 when the mediastinoscopy biopsy targets a mediastinal mass or other mediastinal tissue. Use 39402 when the sampled targets are mediastinal lymph nodes.

Is the biopsy separately reported from the mediastinoscopy?

No. The biopsy is included in the mediastinoscopy service described by this code.

What care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care.

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this procedure.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 39401PPRRVU2026_Oct_nonQPP.csv, line 4,778 (RVU26D)

Open CMS sourceHow we calculate rates

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