No office rate
Choose 39402 for mediastinoscopic sampling of lymph nodes. Code 39401 is associated with mediastinal biopsy that is not described as lymph node biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
39402 Mediastinoscopy Medicare reimbursement rates
Report this service when a surgeon uses mediastinoscopy to obtain mediastinal lymph node tissue, commonly for lung cancer staging or diagnostic evaluation. Compare 39402 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 39402?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 39402 pays more and less
Thoracic surgery
About 39402: Mediastinoscopic mediastinal lymph node biopsy
Report this service when a surgeon uses mediastinoscopy to obtain mediastinal lymph node tissue, commonly for lung cancer staging or diagnostic evaluation.
A thoracic surgeon advances a mediastinoscope through an incision at the base of the neck to reach mediastinal lymph nodes and obtain tissue for pathology. A common use is sampling nodes to stage lung cancer; mediastinal lymphadenopathy or suspected lymphoma may also prompt tissue diagnosis. The service is typically performed in a hospital operating room under anesthesia.
Report the code when lymph node tissue is sampled through the mediastinoscopic approach; the biopsy is part of the service, rather than a separate biopsy charge for those nodes. The operative report should identify the approach and sampled nodal sites. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
CMS billing rules for 39402
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.07 · 63%
- Practice expense (office) RVU2.48 · 22%
- Malpractice RVU1.76 · 16%
1.3K
Medicare services in 2024 · #2771 by national volume
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.
39402 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
39499
No office rateUnlisted px mediastinum
Use 39402 when the service is mediastinoscopic lymph node biopsy. The unlisted code is for a mediastinal procedure that lacks a specific listed code.
No office rate
Code 32606 describes diagnostic thoracoscopy with mediastinal tissue biopsy; 39402 describes lymph node sampling by mediastinoscopy.
See how rates vary across the country
39402 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 39402 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $341.90 |
| Alaska* | Office Unavailable | Facility $474.83 |
| Arizona | Office Unavailable | Facility $366.73 |
| Arkansas | Office Unavailable | Facility $337.57 |
| Atlanta | Office Unavailable | Facility $391.61 |
| Austin | Office Unavailable | Facility $376.34 |
| Bakersfield | Office Unavailable | Facility $367.22 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $401.52 |
| Beaumont | Office Unavailable | Facility $366.14 |
| Brazoria | Office Unavailable | Facility $365.97 |
| Chicago | Office Unavailable | Facility $455.96 |
| Chico | Office Unavailable | Facility $362.45 |
| Colorado | Office Unavailable | Facility $373.03 |
| Connecticut | Office Unavailable | Facility $401.21 |
| Dallas | Office Unavailable | Facility $371.21 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $411.90 |
| Delaware | Office Unavailable | Facility $372.01 |
| Detroit | Office Unavailable | Facility $415.19 |
| East St. Louis | Office Unavailable | Facility $430.75 |
| El Centro | Office Unavailable | Facility $362.75 |
| Fort Lauderdale | Office Unavailable | Facility $426.34 |
| Fort Worth | Office Unavailable | Facility $371.15 |
| Fresno | Office Unavailable | Facility $362.45 |
| Galveston | Office Unavailable | Facility $368.96 |
| Hanford-Corcoran | Office Unavailable | Facility $362.45 |
| Hawaii, Guam | Office Unavailable | Facility $364.36 |
| Houston | Office Unavailable | Facility $401.18 |
| Idaho | Office Unavailable | Facility $340.16 |
| Indiana | Office Unavailable | Facility $341.50 |
| Iowa | Office Unavailable | Facility $335.28 |
| Kansas | Office Unavailable | Facility $340.65 |
| Kentucky | Office Unavailable | Facility $363.57 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $382.85 |
| Madera | Office Unavailable | Facility $362.45 |
| Manhattan | Office Unavailable | Facility $440.74 |
| Merced | Office Unavailable | Facility $362.45 |
| Metropolitan Boston | Office Unavailable | Facility $397.05 |
| Metropolitan Kansas City | Office Unavailable | Facility $371.36 |
| Metropolitan Philadelphia | Office Unavailable | Facility $396.76 |
| Metropolitan St. Louis | Office Unavailable | Facility $373.91 |
| Miami | Office Unavailable | Facility $471.04 |
| Minnesota | Office Unavailable | Facility $338.78 |
| Mississippi | Office Unavailable | Facility $350.91 |
| Modesto | Office Unavailable | Facility $362.45 |
| Montana** | Office Unavailable | Facility $377.65 |
| Napa | Office Unavailable | Facility $390.06 |
| Nebraska | Office Unavailable | Facility $334.82 |
| Nevada** | Office Unavailable | Facility $368.03 |
| New Hampshire | Office Unavailable | Facility $373.81 |
| New Mexico | Office Unavailable | Facility $382.70 |
| New Orleans | Office Unavailable | Facility $380.87 |
| North Carolina | Office Unavailable | Facility $350.99 |
| North Dakota** | Office Unavailable | Facility $342.85 |
| Northern Nj | Office Unavailable | Facility $409.89 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $458.91 |
| Ohio | Office Unavailable | Facility $371.03 |
| Oklahoma | Office Unavailable | Facility $355.79 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $377.29 |
| Portland | Office Unavailable | Facility $375.69 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $408.60 |
| Puerto Rico | Office Unavailable | Facility $377.79 |
| Queens | Office Unavailable | Facility $433.94 |
| Redding | Office Unavailable | Facility $362.45 |
| Rest Of California | Office Unavailable | Facility $362.45 |
| Rest Of Florida | Office Unavailable | Facility $403.69 |
| Rest Of Georgia | Office Unavailable | Facility $380.10 |
| Rest Of Illinois | Office Unavailable | Facility $403.65 |
| Rest Of Louisiana | Office Unavailable | Facility $365.77 |
| Rest Of Maine | Office Unavailable | Facility $348.92 |
| Rest Of Maryland | Office Unavailable | Facility $376.30 |
| Rest Of Massachusetts | Office Unavailable | Facility $374.00 |
| Rest Of Michigan | Office Unavailable | Facility $378.14 |
| Rest Of Missouri | Office Unavailable | Facility $364.80 |
| Rest Of New Jersey | Office Unavailable | Facility $400.53 |
| Rest Of New York | Office Unavailable | Facility $356.16 |
| Rest Of Oregon | Office Unavailable | Facility $359.97 |
| Rest Of Pennsylvania | Office Unavailable | Facility $367.74 |
| Rest Of Texas | Office Unavailable | Facility $367.84 |
| Rest Of Washington | Office Unavailable | Facility $371.17 |
| Rhode Island | Office Unavailable | Facility $378.64 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $381.33 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $372.49 |
| Salinas | Office Unavailable | Facility $370.98 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $374.16 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $402.36 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $400.36 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $413.08 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $404.91 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $366.02 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $373.26 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $370.85 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $376.46 |
| Seattle (King Cnty) | Office Unavailable | Facility $397.62 |
| South Carolina | Office Unavailable | Facility $362.65 |
| South Dakota** | Office Unavailable | Facility $338.73 |
| Southern Maine | Office Unavailable | Facility $355.33 |
| Stockton | Office Unavailable | Facility $362.45 |
| Suburban Chicago | Office Unavailable | Facility $427.04 |
| Tennessee | Office Unavailable | Facility $343.01 |
| Utah | Office Unavailable | Facility $366.80 |
| Vallejo | Office Unavailable | Facility $387.18 |
| Vermont | Office Unavailable | Facility $347.90 |
| Virgin Islands | Office Unavailable | Facility $377.79 |
| Virginia | Office Unavailable | Facility $359.07 |
| Visalia | Office Unavailable | Facility $362.45 |
| West Virginia | Office Unavailable | Facility $392.25 |
| Wisconsin | Office Unavailable | Facility $333.61 |
| Wyoming** | Office Unavailable | Facility $362.48 |
| Yuba City | Office Unavailable | Facility $362.45 |
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39402 billing questions
How is this distinguished from 39401?
Use 39402 when mediastinoscopy is used to biopsy mediastinal lymph nodes. Code 39401 is associated with mediastinal biopsy rather than lymph node biopsy.
Can the sampled lymph node biopsy be billed separately?
No. The lymph node sampling is included in the mediastinoscopic service; do not report a separate biopsy charge for tissue obtained through this procedure.
What documentation supports reporting 39402?
The operative report should establish the mediastinoscopic approach and identify the mediastinal lymph node sites sampled.
Should modifier 50 be appended when nodes on both sides are sampled?
No. Modifier 50 is inappropriate for this code, even when the operative report describes sampling on both sides.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 39402. Co-surgeons and team surgery are 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,77639200,,Resect mediastinal cyst,A,,14.71,6.49,NA,6.49,,3.70,24.90,24.90,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,77739220,,Resect mediastinal tumor,A,,19.06,8.47,NA,8.47,,4.44,31.97,31.97,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,77839401,,Mediastinoscpy w/medstnl bx,A,,5.30,2.14,NA,2.14,,1.32,8.76,8.76,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,77939402,,Mediastinoscpy w/lmph nod bx,A,,7.07,2.48,NA,2.48,,1.76,11.31,11.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78039499,,Unlisted px mediastinum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78139501,,Repair diaphragm laceration,A,,13.63,7.31,NA,7.31,,3.31,24.25,24.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78239503,,Repair of diaphragm hernia,A,,106.19,27.29,NA,27.29,,26.77,160.25,160.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00