No office rate
Use 38381 for thoracic duct ligation through a cervical approach; use this code when the ligation is performed through the chest.
On this page
CMS RVU26D · Effective 2026-10-01
38382 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$661.87
Base rate per service
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.
Lymphatic surgery
About 38382: Thoracic-approach thoracic duct ligation
Reports surgical ligation of the thoracic duct through a thoracic approach, commonly to control a persistent chyle leak or chylothorax.
This code describes operative ligation of the thoracic duct through the chest. Thoracic or general surgeons may perform it to control a persistent chyle leak, including chylothorax after thoracic surgery or injury. The service involves identifying the duct and securing it to stop chyle flow; it is distinct from repairing the duct or treating a lymph node lesion.
Select the code when the documented operation ligates the thoracic duct using a thoracic approach, rather than a cervical approach. The operative report should identify the duct, the approach, and the ligation performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. 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 multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 38382
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.38 · 52%
- Practice expense (office) RVU7.16 · 36%
- Malpractice RVU2.61 · 13%
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.
38382 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
Code 38380 describes repair of the thoracic duct. This code describes ligation through a thoracic approach.
No office rate
Code 38308 concerns incision of lymphatic channels, not ligation of the thoracic duct through the chest.
The same code, a different location
How does El Centro compare?
38382 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 38382
Office
Unavailable
Facility
$661.43
No comparable office rate is available.
Modesto
California · 38382
Office
Unavailable
Facility
$661.43
No comparable office rate is available.
Napa
California · 38382
Office
Unavailable
Facility
$728.03
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 38382
Office
Unavailable
Facility
$693.40
No comparable office rate is available.
Redding
California · 38382
Office
Unavailable
Facility
$661.43
No comparable office rate is available.
Rest Of California
California · 38382
Office
Unavailable
Facility
$661.43
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 38382
Office
Unavailable
Facility
$689.41
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 38382
Office
Unavailable
Facility
$684.04
No comparable office rate is available.
Salinas
California · 38382
Office
Unavailable
Facility
$681.35
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 38382
Office
Unavailable
Facility
$690.38
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 38382
Office
Unavailable
Facility
$756.85
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 38382
Office
Unavailable
Facility
$753.89
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 38382
Office
Unavailable
Facility
$776.42
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 38382
Office
Unavailable
Facility
$764.30
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 38382
Office
Unavailable
Facility
$671.71
No comparable office rate is available.
Santa Cruz-Watsonville
California · 38382
Office
Unavailable
Facility
$691.28
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 38382
Office
Unavailable
Facility
$681.98
No comparable office rate is available.
Santa Rosa-Petaluma
California · 38382
Office
Unavailable
Facility
$697.51
No comparable office rate is available.
Stockton
California · 38382
Office
Unavailable
Facility
$661.43
No comparable office rate is available.
Vallejo
California · 38382
Office
Unavailable
Facility
$723.76
No comparable office rate is available.
Visalia
California · 38382
Office
Unavailable
Facility
$661.43
No comparable office rate is available.
Yuba City
California · 38382
Office
Unavailable
Facility
$661.43
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 38382
Office
Unavailable
Facility
$744.17
No comparable office rate is available.
Miami
Florida · 38382
Office
Unavailable
Facility
$816.13
No comparable office rate is available.
Chicago
Illinois · 38382
Office
Unavailable
Facility
$789.54
No comparable office rate is available.
Manhattan
New York · 38382
Office
Unavailable
Facility
$785.04
No comparable office rate is available.
Alaska*
Alaska · 38382
Office
Unavailable
Facility
$822.78
No comparable office rate is available.
Alabama
Alabama · 38382
Office
Unavailable
Facility
$605.30
No comparable office rate is available.
Arkansas
Arkansas · 38382
Office
Unavailable
Facility
$597.03
No comparable office rate is available.
Arizona
Arizona · 38382
Office
Unavailable
Facility
$653.06
No comparable office rate is available.
Colorado
Colorado · 38382
Office
Unavailable
Facility
$673.40
No comparable office rate is available.
Connecticut
Connecticut · 38382
Office
Unavailable
Facility
$716.68
No comparable office rate is available.
Delaware
Delaware · 38382
Office
Unavailable
Facility
$663.09
No comparable office rate is available.
Fort Lauderdale
Florida · 38382
Office
Unavailable
Facility
$746.58
No comparable office rate is available.
Rest Of Florida
Florida · 38382
Office
Unavailable
Facility
$706.36
No comparable office rate is available.
Atlanta
Georgia · 38382
Office
Unavailable
Facility
$695.42
No comparable office rate is available.
Rest Of Georgia
Georgia · 38382
Office
Unavailable
Facility
$663.94
No comparable office rate is available.
Hawaii, Guam
Hawaii · 38382
Office
Unavailable
Facility
$669.09
No comparable office rate is available.
Iowa
Iowa · 38382
Office
Unavailable
Facility
$600.13
No comparable office rate is available.
Idaho
Idaho · 38382
Office
Unavailable
Facility
$607.95
No comparable office rate is available.
East St. Louis
Illinois · 38382
Office
Unavailable
Facility
$742.29
No comparable office rate is available.
Rest Of Illinois
Illinois · 38382
Office
Unavailable
Facility
$701.30
No comparable office rate is available.
Suburban Chicago
Illinois · 38382
Office
Unavailable
Facility
$749.21
No comparable office rate is available.
Indiana
Indiana · 38382
Office
Unavailable
Facility
$610.76
No comparable office rate is available.
Kansas
Kansas · 38382
Office
Unavailable
Facility
$606.83
No comparable office rate is available.
Kentucky
Kentucky · 38382
Office
Unavailable
Facility
$639.07
No comparable office rate is available.
New Orleans
Louisiana · 38382
Office
Unavailable
Facility
$670.77
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 38382
Office
Unavailable
Facility
$641.86
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 38382
Office
Unavailable
Facility
$724.05
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 38382
Office
Unavailable
Facility
$673.55
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 38382
Office
Unavailable
Facility
$716.69
No comparable office rate is available.
Rest Of Maryland
Maryland · 38382
Office
Unavailable
Facility
$672.22
No comparable office rate is available.
Rest Of Maine
Maine · 38382
Office
Unavailable
Facility
$620.94
No comparable office rate is available.
Southern Maine
Maine · 38382
Office
Unavailable
Facility
$638.71
No comparable office rate is available.
Detroit
Michigan · 38382
Office
Unavailable
Facility
$724.46
No comparable office rate is available.
Rest Of Michigan
Michigan · 38382
Office
Unavailable
Facility
$663.47
No comparable office rate is available.
Minnesota
Minnesota · 38382
Office
Unavailable
Facility
$618.59
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 38382
Office
Unavailable
Facility
$656.43
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 38382
Office
Unavailable
Facility
$661.72
No comparable office rate is available.
Rest Of Missouri
Missouri · 38382
Office
Unavailable
Facility
$637.76
No comparable office rate is available.
Mississippi
Mississippi · 38382
Office
Unavailable
Facility
$617.03
No comparable office rate is available.
Montana**
Montana · 38382
Office
Unavailable
Facility
$672.85
No comparable office rate is available.
North Carolina
North Carolina · 38382
Office
Unavailable
Facility
$625.53
No comparable office rate is available.
North Dakota**
North Dakota · 38382
Office
Unavailable
Facility
$621.25
No comparable office rate is available.
Nebraska
Nebraska · 38382
Office
Unavailable
Facility
$600.39
No comparable office rate is available.
New Hampshire
New Hampshire · 38382
Office
Unavailable
Facility
$671.94
No comparable office rate is available.
Northern Nj
New Jersey · 38382
Office
Unavailable
Facility
$739.06
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 38382
Office
Unavailable
Facility
$717.35
No comparable office rate is available.
New Mexico
New Mexico · 38382
Office
Unavailable
Facility
$670.70
No comparable office rate is available.
Nevada**
Nevada · 38382
Office
Unavailable
Facility
$658.71
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 38382
Office
Unavailable
Facility
$815.13
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 38382
Office
Unavailable
Facility
$729.66
No comparable office rate is available.
Queens
New York · 38382
Office
Unavailable
Facility
$777.27
No comparable office rate is available.
Rest Of New York
New York · 38382
Office
Unavailable
Facility
$635.18
No comparable office rate is available.
Ohio
Ohio · 38382
Office
Unavailable
Facility
$652.92
No comparable office rate is available.
Oklahoma
Oklahoma · 38382
Office
Unavailable
Facility
$628.00
No comparable office rate is available.
Portland
Oregon · 38382
Office
Unavailable
Facility
$682.80
No comparable office rate is available.
Rest Of Oregon
Oregon · 38382
Office
Unavailable
Facility
$646.18
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 38382
Office
Unavailable
Facility
$705.90
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 38382
Office
Unavailable
Facility
$648.62
No comparable office rate is available.
Puerto Rico
Puerto Rico · 38382
Office
Unavailable
Facility
$674.35
No comparable office rate is available.
Rhode Island
Rhode Island · 38382
Office
Unavailable
Facility
$678.09
No comparable office rate is available.
South Carolina
South Carolina · 38382
Office
Unavailable
Facility
$641.78
No comparable office rate is available.
South Dakota**
South Dakota · 38382
Office
Unavailable
Facility
$615.14
No comparable office rate is available.
Tennessee
Tennessee · 38382
Office
Unavailable
Facility
$610.90
No comparable office rate is available.
Austin
Texas · 38382
Office
Unavailable
Facility
$677.65
No comparable office rate is available.
Beaumont
Texas · 38382
Office
Unavailable
Facility
$645.32
No comparable office rate is available.
Brazoria
Texas · 38382
Office
Unavailable
Facility
$654.47
No comparable office rate is available.
Dallas
Texas · 38382
Office
Unavailable
Facility
$662.81
No comparable office rate is available.
Fort Worth
Texas · 38382
Office
Unavailable
Facility
$661.55
No comparable office rate is available.
Galveston
Texas · 38382
Office
Unavailable
Facility
$659.13
No comparable office rate is available.
Houston
Texas · 38382
Office
Unavailable
Facility
$706.91
No comparable office rate is available.
Rest Of Texas
Texas · 38382
Office
Unavailable
Facility
$652.38
No comparable office rate is available.
Utah
Utah · 38382
Office
Unavailable
Facility
$649.79
No comparable office rate is available.
Virginia
Virginia · 38382
Office
Unavailable
Facility
$643.33
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 38382
Office
Unavailable
Facility
$674.35
No comparable office rate is available.
Vermont
Vermont · 38382
Office
Unavailable
Facility
$627.57
No comparable office rate is available.
Rest Of Washington
Washington · 38382
Office
Unavailable
Facility
$669.38
No comparable office rate is available.
Seattle (King Cnty)
Washington · 38382
Office
Unavailable
Facility
$728.70
No comparable office rate is available.
Wisconsin
Wisconsin · 38382
Office
Unavailable
Facility
$602.66
No comparable office rate is available.
West Virginia
West Virginia · 38382
Office
Unavailable
Facility
$679.27
No comparable office rate is available.
Wyoming**
Wyoming · 38382
Office
Unavailable
Facility
$650.36
No comparable office rate is available.
See how rates vary across the country
38382 · 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 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 38382 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$728.06
$661.87 × 110% = $728.06
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 38382 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
4,740
- Code
- 38382
- Physician work
- 10.38
- Practice expense
- 7.16
- Malpractice
- 2.61
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.38 | × 1.017 | 10.5565 |
| Practice expense | 7.16 | × 1.096 | 7.8474 |
| Malpractice | 2.61 | × 0.541 | 1.4120 |
| Total RVUs | 19.8158 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$661.87
Open 38382 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.38 | 1.017 |
| Practice expense | 7.16 | 1.096 |
| Malpractice | 2.61 | 0.541 |
(10.38 × 1.017 + 7.16 × 1.096 + 2.61 × 0.541) × $33.4009 = $661.87
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
38382 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $661.87 | RVU26D |
| 2026-07-01 | Not available in this setting | $661.87 | RVU26C |
| 2026-04-01 | Not available in this setting | $661.87 | RVU26B |
| 2026-01-01 | Not available in this setting | $661.87 | RVU26A |
| 2025-10-01 | Not available in this setting | $654.11 | RVU25D |
| 2025-07-01 | Not available in this setting | $654.11 | RVU25C |
| 2025-04-01 | Not available in this setting | $654.11 | RVU25B |
| 2025-01-01 | Not available in this setting | $654.11 | RVU25A |
38382 billing questions
How is this code distinguished from 38381?
Both describe thoracic duct ligation, but this code is for a thoracic approach. Code 38381 is for a cervical approach.
When would 38380 be reported instead?
Code 38380 describes repair of the thoracic duct. This code applies when the surgeon ligates the duct through the chest rather than repairing it.
What documentation supports reporting this code?
The operative report should establish that the thoracic duct was ligated and that the surgeon used a thoracic approach. Documentation of a chyle leak alone does not establish the specific procedure.
Does the 90-day global period include postoperative care?
Yes. The global period includes the day-before preoperative visit and related postoperative care for 90 days after the operation.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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% when performed in the same session.
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.
4,73738308,,Incision of lymph channels,A,,6.64,5.25,NA,5.25,,1.51,13.40,13.40,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73838380,,Thoracic duct procedure,A,,8.25,5.94,NA,5.94,,1.33,15.52,15.52,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73938381,,Thoracic duct procedure,A,,13.05,6.84,NA,6.84,,3.21,23.10,23.10,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74038382,,Thoracic duct procedure,A,,10.38,7.16,NA,7.16,,2.61,20.15,20.15,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74138500,,Biopsy/removal lymph nodes,A,,3.70,6.46,,2.75,,0.90,11.06,7.35,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74238505,,Needle biopsy lymph nodes,A,,1.55,3.38,,0.52,,0.17,5.10,2.24,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74338510,,Biopsy/removal lymph nodes,A,,6.57,8.66,,3.48,,1.27,16.50,11.32,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664