$397.28
Choose 38300 when the operation drains a lymph node lesion. Choose 38308 when the surgeon incises lymphatic channels themselves.
On this page
CMS RVU26D · Effective 2026-10-01
38308 in Madera
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$444.77
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 38308: Incision of lymphatic channels
Reports an operative incision into lymphatic channels when the surgeon directly treats the channels rather than draining a lymph node lesion.
A surgeon reports 38308 for an operation in which the lymphatic channels themselves are incised. The operative target is the lymphatic pathway, not a lymph node or a lesion within a lymph node. This is a facility-based surgical service; Medicare recorded facility services for the code in 2024 and no office services. The code is distinct from procedures directed at the thoracic duct, which have separate codes.
The operative report should identify the lymphatic channels treated and describe the incision performed, so the record distinguishes this work from lymph node drainage. This major procedure has a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and other procedures at half their value. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 38308
- 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 RVU6.64 · 50%
- Practice expense (office) RVU5.25 · 39%
- Malpractice RVU1.51 · 11%
160
Medicare services in 2024 · #4511 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.
38308 compared with similar codes
Office rates for Madera, from the same CMS release.
No office rate
38305 is for drainage directed at a lymph node lesion; 38308 describes an incision directed at lymphatic channels.
No office rate
38380 is a thoracic duct procedure. Use 38308 when the operation is directed at lymphatic channels rather than specifically at the thoracic duct.
The same code, a different location
How does Madera compare?
38308 across payment areas
Same release and payment basis · bars start at $0
Madera · 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.
Unavailable
No comparable rate is available in this setting.
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 · 38308
Office
Unavailable
Facility
$444.77
No comparable office rate is available.
Modesto
California · 38308
Office
Unavailable
Facility
$444.77
No comparable office rate is available.
Napa
California · 38308
Office
Unavailable
Facility
$492.49
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 38308
Office
Unavailable
Facility
$466.68
No comparable office rate is available.
Redding
California · 38308
Office
Unavailable
Facility
$444.77
No comparable office rate is available.
Rest Of California
California · 38308
Office
Unavailable
Facility
$444.77
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 38308
Office
Unavailable
Facility
$460.98
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 38308
Office
Unavailable
Facility
$460.74
No comparable office rate is available.
Salinas
California · 38308
Office
Unavailable
Facility
$458.93
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 38308
Office
Unavailable
Facility
$465.50
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 38308
Office
Unavailable
Facility
$513.25
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 38308
Office
Unavailable
Facility
$511.54
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 38308
Office
Unavailable
Facility
$526.07
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 38308
Office
Unavailable
Facility
$519.06
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 38308
Office
Unavailable
Facility
$452.31
No comparable office rate is available.
Santa Cruz-Watsonville
California · 38308
Office
Unavailable
Facility
$466.53
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 38308
Office
Unavailable
Facility
$459.49
No comparable office rate is available.
Santa Rosa-Petaluma
California · 38308
Office
Unavailable
Facility
$470.80
No comparable office rate is available.
Stockton
California · 38308
Office
Unavailable
Facility
$444.77
No comparable office rate is available.
Vallejo
California · 38308
Office
Unavailable
Facility
$490.02
No comparable office rate is available.
Visalia
California · 38308
Office
Unavailable
Facility
$444.77
No comparable office rate is available.
Yuba City
California · 38308
Office
Unavailable
Facility
$444.77
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 38308
Office
Unavailable
Facility
$496.46
No comparable office rate is available.
Miami
Florida · 38308
Office
Unavailable
Facility
$531.88
No comparable office rate is available.
Chicago
Illinois · 38308
Office
Unavailable
Facility
$515.32
No comparable office rate is available.
Manhattan
New York · 38308
Office
Unavailable
Facility
$519.73
No comparable office rate is available.
Alaska*
Alaska · 38308
Office
Unavailable
Facility
$547.22
No comparable office rate is available.
Alabama
Alabama · 38308
Office
Unavailable
Facility
$403.76
No comparable office rate is available.
Arkansas
Arkansas · 38308
Office
Unavailable
Facility
$398.39
No comparable office rate is available.
Arizona
Arizona · 38308
Office
Unavailable
Facility
$434.87
No comparable office rate is available.
Colorado
Colorado · 38308
Office
Unavailable
Facility
$450.41
No comparable office rate is available.
Connecticut
Connecticut · 38308
Office
Unavailable
Facility
$476.10
No comparable office rate is available.
Delaware
Delaware · 38308
Office
Unavailable
Facility
$441.48
No comparable office rate is available.
Fort Lauderdale
Florida · 38308
Office
Unavailable
Facility
$490.60
No comparable office rate is available.
Rest Of Florida
Florida · 38308
Office
Unavailable
Facility
$465.23
No comparable office rate is available.
Atlanta
Georgia · 38308
Office
Unavailable
Facility
$461.18
No comparable office rate is available.
Rest Of Georgia
Georgia · 38308
Office
Unavailable
Facility
$438.32
No comparable office rate is available.
Hawaii, Guam
Hawaii · 38308
Office
Unavailable
Facility
$450.36
No comparable office rate is available.
Iowa
Iowa · 38308
Office
Unavailable
Facility
$402.25
No comparable office rate is available.
Idaho
Idaho · 38308
Office
Unavailable
Facility
$406.96
No comparable office rate is available.
East St. Louis
Illinois · 38308
Office
Unavailable
Facility
$484.69
No comparable office rate is available.
Rest Of Illinois
Illinois · 38308
Office
Unavailable
Facility
$460.71
No comparable office rate is available.
Suburban Chicago
Illinois · 38308
Office
Unavailable
Facility
$492.80
No comparable office rate is available.
Indiana
Indiana · 38308
Office
Unavailable
Facility
$408.85
No comparable office rate is available.
Kansas
Kansas · 38308
Office
Unavailable
Facility
$405.72
No comparable office rate is available.
Kentucky
Kentucky · 38308
Office
Unavailable
Facility
$423.82
No comparable office rate is available.
New Orleans
Louisiana · 38308
Office
Unavailable
Facility
$444.09
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 38308
Office
Unavailable
Facility
$425.29
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 38308
Office
Unavailable
Facility
$485.14
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 38308
Office
Unavailable
Facility
$450.18
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 38308
Office
Unavailable
Facility
$475.87
No comparable office rate is available.
Rest Of Maryland
Maryland · 38308
Office
Unavailable
Facility
$447.76
No comparable office rate is available.
Rest Of Maine
Maine · 38308
Office
Unavailable
Facility
$414.48
No comparable office rate is available.
Southern Maine
Maine · 38308
Office
Unavailable
Facility
$427.38
No comparable office rate is available.
Detroit
Michigan · 38308
Office
Unavailable
Facility
$476.03
No comparable office rate is available.
Rest Of Michigan
Michigan · 38308
Office
Unavailable
Facility
$438.82
No comparable office rate is available.
Minnesota
Minnesota · 38308
Office
Unavailable
Facility
$417.15
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 38308
Office
Unavailable
Facility
$435.72
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 38308
Office
Unavailable
Facility
$439.26
No comparable office rate is available.
Rest Of Missouri
Missouri · 38308
Office
Unavailable
Facility
$422.06
No comparable office rate is available.
Mississippi
Mississippi · 38308
Office
Unavailable
Facility
$410.03
No comparable office rate is available.
Montana**
Montana · 38308
Office
Unavailable
Facility
$447.47
No comparable office rate is available.
North Carolina
North Carolina · 38308
Office
Unavailable
Facility
$417.62
No comparable office rate is available.
North Dakota**
North Dakota · 38308
Office
Unavailable
Facility
$417.61
No comparable office rate is available.
Nebraska
Nebraska · 38308
Office
Unavailable
Facility
$402.70
No comparable office rate is available.
New Hampshire
New Hampshire · 38308
Office
Unavailable
Facility
$448.46
No comparable office rate is available.
Northern Nj
New Jersey · 38308
Office
Unavailable
Facility
$493.03
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 38308
Office
Unavailable
Facility
$477.47
No comparable office rate is available.
New Mexico
New Mexico · 38308
Office
Unavailable
Facility
$443.16
No comparable office rate is available.
Nevada**
Nevada · 38308
Office
Unavailable
Facility
$439.32
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 38308
Office
Unavailable
Facility
$538.13
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 38308
Office
Unavailable
Facility
$484.80
No comparable office rate is available.
Queens
New York · 38308
Office
Unavailable
Facility
$515.97
No comparable office rate is available.
Rest Of New York
New York · 38308
Office
Unavailable
Facility
$423.83
No comparable office rate is available.
Ohio
Ohio · 38308
Office
Unavailable
Facility
$432.72
No comparable office rate is available.
Oklahoma
Oklahoma · 38308
Office
Unavailable
Facility
$417.56
No comparable office rate is available.
Portland
Oregon · 38308
Office
Unavailable
Facility
$457.67
No comparable office rate is available.
Rest Of Oregon
Oregon · 38308
Office
Unavailable
Facility
$431.89
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 38308
Office
Unavailable
Facility
$468.49
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 38308
Office
Unavailable
Facility
$430.42
No comparable office rate is available.
Puerto Rico
Puerto Rico · 38308
Office
Unavailable
Facility
$448.74
No comparable office rate is available.
Rhode Island
Rhode Island · 38308
Office
Unavailable
Facility
$452.13
No comparable office rate is available.
South Carolina
South Carolina · 38308
Office
Unavailable
Facility
$426.68
No comparable office rate is available.
South Dakota**
South Dakota · 38308
Office
Unavailable
Facility
$414.08
No comparable office rate is available.
Tennessee
Tennessee · 38308
Office
Unavailable
Facility
$408.26
No comparable office rate is available.
Austin
Texas · 38308
Office
Unavailable
Facility
$452.44
No comparable office rate is available.
Beaumont
Texas · 38308
Office
Unavailable
Facility
$428.21
No comparable office rate is available.
Brazoria
Texas · 38308
Office
Unavailable
Facility
$436.67
No comparable office rate is available.
Dallas
Texas · 38308
Office
Unavailable
Facility
$441.70
No comparable office rate is available.
Fort Worth
Texas · 38308
Office
Unavailable
Facility
$440.61
No comparable office rate is available.
Galveston
Texas · 38308
Office
Unavailable
Facility
$439.44
No comparable office rate is available.
Houston
Texas · 38308
Office
Unavailable
Facility
$467.08
No comparable office rate is available.
Rest Of Texas
Texas · 38308
Office
Unavailable
Facility
$433.74
No comparable office rate is available.
Utah
Utah · 38308
Office
Unavailable
Facility
$431.91
No comparable office rate is available.
Virginia
Virginia · 38308
Office
Unavailable
Facility
$429.76
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 38308
Office
Unavailable
Facility
$448.74
No comparable office rate is available.
Vermont
Vermont · 38308
Office
Unavailable
Facility
$420.90
No comparable office rate is available.
Rest Of Washington
Washington · 38308
Office
Unavailable
Facility
$447.69
No comparable office rate is available.
Seattle (King Cnty)
Washington · 38308
Office
Unavailable
Facility
$489.24
No comparable office rate is available.
Wisconsin
Wisconsin · 38308
Office
Unavailable
Facility
$405.31
No comparable office rate is available.
West Virginia
West Virginia · 38308
Office
Unavailable
Facility
$446.34
No comparable office rate is available.
Wyoming**
Wyoming · 38308
Office
Unavailable
Facility
$434.46
No comparable office rate is available.
See how rates vary across the country
38308 · 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?
Madera is a Medicare payment area. Our Census mapping connects it to 17 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 38308 in Madera. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$489.25
$444.77 × 110% = $489.25
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 38308 in Madera.
PPRRVU2026_Oct_nonQPP.csv
4,737
- Code
- 38308
- Physician work
- 6.64
- Practice expense
- 5.25
- Malpractice
- 1.51
GPCI2026.csv
14
- Locality
- Madera
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.64 | × 1.017 | 6.7529 |
| Practice expense | 5.25 | × 1.096 | 5.7540 |
| Malpractice | 1.51 | × 0.536 | 0.8094 |
| Total RVUs | 13.3162 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Madera$444.77
Open 38308 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.64 | 1.017 |
| Practice expense | 5.25 | 1.096 |
| Malpractice | 1.51 | 0.536 |
(6.64 × 1.017 + 5.25 × 1.096 + 1.51 × 0.536) × $33.4009 = $444.77
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
38308 · 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 | $444.77 | RVU26D |
| 2026-07-01 | Not available in this setting | $444.77 | RVU26C |
| 2026-04-01 | Not available in this setting | $444.77 | RVU26B |
| 2026-01-01 | Not available in this setting | $444.77 | RVU26A |
| 2025-10-01 | Not available in this setting | $462.34 | RVU25D |
| 2025-07-01 | Not available in this setting | $462.34 | RVU25C |
| 2025-04-01 | Not available in this setting | $462.34 | RVU25B |
| 2025-01-01 | Not available in this setting | $462.34 | RVU25A |
38308 billing questions
How is 38308 different from lymph node drainage?
38308 is for an incision directed at lymphatic channels. Use a lymph node drainage code when the operative target is a lesion in a lymph node.
What documentation supports 38308?
The operative report should identify the lymphatic channels treated and describe the incision. This helps distinguish the service from drainage of a lymph node lesion or a thoracic duct procedure.
Are the preoperative visit and postoperative visits separately included?
The day-before preoperative visit and related postoperative care during the 90-day global period are included in the surgical payment.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are paid at half their value under 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 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.
4,73438243,,Transplj hematopoietic boost,A,,2.08,0.82,NA,0.82,,0.14,3.04,3.04,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73538300,,Drainage lymph node lesion,A,,2.30,8.42,,3.56,,0.61,11.33,6.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73638305,,Drainage lymph node lesion,A,,6.51,6.46,NA,6.46,,1.74,14.71,14.71,0,090,0.11,0.73,0.16,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508