No office rate
Use 38760 for superficial inguinofemoral node removal without pelvic lymphadenectomy. Choose 38765 when the operation includes both groin and pelvic nodes.
On this page
CMS RVU26D · Effective 2026-10-01
38765 in Madera
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1196.42
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 38765: Inguinofemoral and pelvic lymphadenectomy
Reports surgical removal of inguinofemoral nodes together with pelvic nodes, such as for selected cancers with regional nodal disease.
This operation removes lymph nodes in the groin and pelvis as a combined regional dissection. Surgical oncologists, gynecologic oncologists, or urologists may perform it in an operating room for cancers that spread to these nodal areas, including vulvar or penile cancer and melanoma. The code distinguishes this combined operation from groin-only or pelvic-only node removal.
Report the service when the operative documentation supports both inguinofemoral and pelvic lymph node dissection; document the sites treated and the extent of the operation. The pelvic dissection is included in this combined service, so do not separately report pelvic lymphadenectomy for the same work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 38765
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU21.36 · 58%
- Practice expense (office) RVU10.50 · 29%
- Malpractice RVU4.83 · 13%
101
Medicare services in 2024 · #4877 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.
38765 compared with similar codes
Office rates for Madera, from the same CMS release.
No office rate
This code is for pelvic lymphadenectomy alone. The combined groin and pelvic dissection is reported with 38765, not as separate pelvic work.
No office rate
Code 38531 describes open biopsy or excision of inguinofemoral node(s) for limited sampling; 38765 represents a regional dissection that also includes pelvic nodes.
The same code, a different location
How does Madera compare?
38765 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 · 38765
Office
Unavailable
Facility
$1196.42
No comparable office rate is available.
Modesto
California · 38765
Office
Unavailable
Facility
$1196.42
No comparable office rate is available.
Napa
California · 38765
Office
Unavailable
Facility
$1302.58
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 38765
Office
Unavailable
Facility
$1248.46
No comparable office rate is available.
Redding
California · 38765
Office
Unavailable
Facility
$1196.42
No comparable office rate is available.
Rest Of California
California · 38765
Office
Unavailable
Facility
$1196.42
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 38765
Office
Unavailable
Facility
$1248.27
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 38765
Office
Unavailable
Facility
$1233.47
No comparable office rate is available.
Salinas
California · 38765
Office
Unavailable
Facility
$1228.50
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 38765
Office
Unavailable
Facility
$1241.73
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 38765
Office
Unavailable
Facility
$1349.77
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 38765
Office
Unavailable
Facility
$1344.28
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 38765
Office
Unavailable
Facility
$1384.12
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 38765
Office
Unavailable
Facility
$1361.69
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 38765
Office
Unavailable
Facility
$1211.50
No comparable office rate is available.
Santa Cruz-Watsonville
California · 38765
Office
Unavailable
Facility
$1241.01
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 38765
Office
Unavailable
Facility
$1228.82
No comparable office rate is available.
Santa Rosa-Petaluma
California · 38765
Office
Unavailable
Facility
$1251.99
No comparable office rate is available.
Stockton
California · 38765
Office
Unavailable
Facility
$1196.42
No comparable office rate is available.
Vallejo
California · 38765
Office
Unavailable
Facility
$1294.67
No comparable office rate is available.
Visalia
California · 38765
Office
Unavailable
Facility
$1196.42
No comparable office rate is available.
Yuba City
California · 38765
Office
Unavailable
Facility
$1196.42
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 38765
Office
Unavailable
Facility
$1344.66
No comparable office rate is available.
Miami
Florida · 38765
Office
Unavailable
Facility
$1486.53
No comparable office rate is available.
Chicago
Illinois · 38765
Office
Unavailable
Facility
$1441.14
No comparable office rate is available.
Manhattan
New York · 38765
Office
Unavailable
Facility
$1422.49
No comparable office rate is available.
Alaska*
Alaska · 38765
Office
Unavailable
Facility
$1532.56
No comparable office rate is available.
Alabama
Alabama · 38765
Office
Unavailable
Facility
$1111.62
No comparable office rate is available.
Arkansas
Arkansas · 38765
Office
Unavailable
Facility
$1097.79
No comparable office rate is available.
Arizona
Arizona · 38765
Office
Unavailable
Facility
$1191.38
No comparable office rate is available.
Colorado
Colorado · 38765
Office
Unavailable
Facility
$1221.16
No comparable office rate is available.
Connecticut
Connecticut · 38765
Office
Unavailable
Facility
$1300.63
No comparable office rate is available.
Delaware
Delaware · 38765
Office
Unavailable
Facility
$1208.54
No comparable office rate is available.
Fort Lauderdale
Florida · 38765
Office
Unavailable
Facility
$1360.39
No comparable office rate is available.
Rest Of Florida
Florida · 38765
Office
Unavailable
Facility
$1291.19
No comparable office rate is available.
Atlanta
Georgia · 38765
Office
Unavailable
Facility
$1265.66
No comparable office rate is available.
Rest Of Georgia
Georgia · 38765
Office
Unavailable
Facility
$1218.58
No comparable office rate is available.
Hawaii, Guam
Hawaii · 38765
Office
Unavailable
Facility
$1205.61
No comparable office rate is available.
Iowa
Iowa · 38765
Office
Unavailable
Facility
$1098.39
No comparable office rate is available.
Idaho
Idaho · 38765
Office
Unavailable
Facility
$1112.40
No comparable office rate is available.
East St. Louis
Illinois · 38765
Office
Unavailable
Facility
$1361.01
No comparable office rate is available.
Rest Of Illinois
Illinois · 38765
Office
Unavailable
Facility
$1285.79
No comparable office rate is available.
Suburban Chicago
Illinois · 38765
Office
Unavailable
Facility
$1364.49
No comparable office rate is available.
Indiana
Indiana · 38765
Office
Unavailable
Facility
$1116.96
No comparable office rate is available.
Kansas
Kansas · 38765
Office
Unavailable
Facility
$1111.79
No comparable office rate is available.
Kentucky
Kentucky · 38765
Office
Unavailable
Facility
$1172.84
No comparable office rate is available.
New Orleans
Louisiana · 38765
Office
Unavailable
Facility
$1226.73
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 38765
Office
Unavailable
Facility
$1178.37
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 38765
Office
Unavailable
Facility
$1305.02
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 38765
Office
Unavailable
Facility
$1222.73
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 38765
Office
Unavailable
Facility
$1300.73
No comparable office rate is available.
Rest Of Maryland
Maryland · 38765
Office
Unavailable
Facility
$1223.59
No comparable office rate is available.
Rest Of Maine
Maine · 38765
Office
Unavailable
Facility
$1136.44
No comparable office rate is available.
Southern Maine
Maine · 38765
Office
Unavailable
Facility
$1162.79
No comparable office rate is available.
Detroit
Michigan · 38765
Office
Unavailable
Facility
$1323.87
No comparable office rate is available.
Rest Of Michigan
Michigan · 38765
Office
Unavailable
Facility
$1215.78
No comparable office rate is available.
Minnesota
Minnesota · 38765
Office
Unavailable
Facility
$1122.08
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 38765
Office
Unavailable
Facility
$1200.38
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 38765
Office
Unavailable
Facility
$1208.97
No comparable office rate is available.
Rest Of Missouri
Missouri · 38765
Office
Unavailable
Facility
$1172.89
No comparable office rate is available.
Mississippi
Mississippi · 38765
Office
Unavailable
Facility
$1134.62
No comparable office rate is available.
Montana**
Montana · 38765
Office
Unavailable
Facility
$1225.16
No comparable office rate is available.
North Carolina
North Carolina · 38765
Office
Unavailable
Facility
$1143.74
No comparable office rate is available.
North Dakota**
North Dakota · 38765
Office
Unavailable
Facility
$1129.65
No comparable office rate is available.
Nebraska
Nebraska · 38765
Office
Unavailable
Facility
$1098.13
No comparable office rate is available.
New Hampshire
New Hampshire · 38765
Office
Unavailable
Facility
$1219.69
No comparable office rate is available.
Northern Nj
New Jersey · 38765
Office
Unavailable
Facility
$1337.51
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 38765
Office
Unavailable
Facility
$1301.93
No comparable office rate is available.
New Mexico
New Mexico · 38765
Office
Unavailable
Facility
$1228.80
No comparable office rate is available.
Nevada**
Nevada · 38765
Office
Unavailable
Facility
$1198.89
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 38765
Office
Unavailable
Facility
$1475.68
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 38765
Office
Unavailable
Facility
$1324.78
No comparable office rate is available.
Queens
New York · 38765
Office
Unavailable
Facility
$1406.27
No comparable office rate is available.
Rest Of New York
New York · 38765
Office
Unavailable
Facility
$1160.03
No comparable office rate is available.
Ohio
Ohio · 38765
Office
Unavailable
Facility
$1196.26
No comparable office rate is available.
Oklahoma
Oklahoma · 38765
Office
Unavailable
Facility
$1151.98
No comparable office rate is available.
Portland
Oregon · 38765
Office
Unavailable
Facility
$1234.52
No comparable office rate is available.
Rest Of Oregon
Oregon · 38765
Office
Unavailable
Facility
$1176.16
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 38765
Office
Unavailable
Facility
$1283.84
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 38765
Office
Unavailable
Facility
$1187.85
No comparable office rate is available.
Puerto Rico
Puerto Rico · 38765
Office
Unavailable
Facility
$1226.92
No comparable office rate is available.
Rhode Island
Rhode Island · 38765
Office
Unavailable
Facility
$1233.18
No comparable office rate is available.
South Carolina
South Carolina · 38765
Office
Unavailable
Facility
$1174.63
No comparable office rate is available.
South Dakota**
South Dakota · 38765
Office
Unavailable
Facility
$1118.36
No comparable office rate is available.
Tennessee
Tennessee · 38765
Office
Unavailable
Facility
$1118.87
No comparable office rate is available.
Austin
Texas · 38765
Office
Unavailable
Facility
$1228.86
No comparable office rate is available.
Beaumont
Texas · 38765
Office
Unavailable
Facility
$1182.46
No comparable office rate is available.
Brazoria
Texas · 38765
Office
Unavailable
Facility
$1192.54
No comparable office rate is available.
Dallas
Texas · 38765
Office
Unavailable
Facility
$1207.59
No comparable office rate is available.
Fort Worth
Texas · 38765
Office
Unavailable
Facility
$1206.18
No comparable office rate is available.
Galveston
Texas · 38765
Office
Unavailable
Facility
$1200.98
No comparable office rate is available.
Houston
Texas · 38765
Office
Unavailable
Facility
$1289.39
No comparable office rate is available.
Rest Of Texas
Texas · 38765
Office
Unavailable
Facility
$1191.94
No comparable office rate is available.
Utah
Utah · 38765
Office
Unavailable
Facility
$1187.98
No comparable office rate is available.
Virginia
Virginia · 38765
Office
Unavailable
Facility
$1172.09
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 38765
Office
Unavailable
Facility
$1226.92
No comparable office rate is available.
Vermont
Vermont · 38765
Office
Unavailable
Facility
$1142.28
No comparable office rate is available.
Rest Of Washington
Washington · 38765
Office
Unavailable
Facility
$1214.78
No comparable office rate is available.
Seattle (King Cnty)
Washington · 38765
Office
Unavailable
Facility
$1311.24
No comparable office rate is available.
Wisconsin
Wisconsin · 38765
Office
Unavailable
Facility
$1099.11
No comparable office rate is available.
West Virginia
West Virginia · 38765
Office
Unavailable
Facility
$1249.07
No comparable office rate is available.
Wyoming**
Wyoming · 38765
Office
Unavailable
Facility
$1183.53
No comparable office rate is available.
See how rates vary across the country
38765 · 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 38765 in Madera. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1316.06
$1196.42 × 110% = $1316.06
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 38765 in Madera.
PPRRVU2026_Oct_nonQPP.csv
4,766
- Code
- 38765
- Physician work
- 21.36
- Practice expense
- 10.50
- Malpractice
- 4.83
GPCI2026.csv
14
- Locality
- Madera
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.36 | × 1.017 | 21.7231 |
| Practice expense | 10.50 | × 1.096 | 11.5080 |
| Malpractice | 4.83 | × 0.536 | 2.5889 |
| Total RVUs | 35.8200 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Madera$1196.42
Open 38765 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.36 | 1.017 |
| Practice expense | 10.5 | 1.096 |
| Malpractice | 4.83 | 0.536 |
(21.36 × 1.017 + 10.5 × 1.096 + 4.83 × 0.536) × $33.4009 = $1196.42
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
38765 · 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 | $1196.42 | RVU26D |
| 2026-07-01 | Not available in this setting | $1196.42 | RVU26C |
| 2026-04-01 | Not available in this setting | $1196.42 | RVU26B |
| 2026-01-01 | Not available in this setting | $1196.42 | RVU26A |
| 2025-10-01 | Not available in this setting | $1262.47 | RVU25D |
| 2025-07-01 | Not available in this setting | $1262.47 | RVU25C |
| 2025-04-01 | Not available in this setting | $1262.47 | RVU25B |
| 2025-01-01 | Not available in this setting | $1262.47 | RVU25A |
38765 billing questions
How does this differ from 38760?
This code covers groin dissection together with pelvic lymphadenectomy. Code 38760 is for superficial inguinofemoral lymphadenectomy without the pelvic dissection.
Can 38770 be reported separately for the pelvic portion?
Do not separately report 38770 for pelvic node removal included in the combined operation. Use 38770 when the service is pelvic lymphadenectomy without the inguinofemoral dissection.
What documentation supports reporting this code?
The operative report should identify both the inguinofemoral and pelvic nodal regions dissected and describe the procedure performed at each site.
How is bilateral surgery reported?
For bilateral performance, report modifier 50; CMS payment for this bilateral procedure is 150%.
Are assistant or co-surgeon services payable?
CMS permits payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,76338746,,Remove thoracic lymph nodes,A,,4.02,0.81,NA,0.81,,1.02,5.85,5.85,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76438747,,Remove abdominal lymph nodes,A,,4.76,1.22,NA,1.22,,1.19,7.17,7.17,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76538760,,Remove groin lymph nodes,A,,13.28,7.16,NA,7.16,,2.93,23.37,23.37,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76638765,,Remove groin lymph nodes,A,,21.36,10.50,NA,10.50,,4.83,36.69,36.69,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76738770,,Remove pelvis lymph nodes,A,,13.71,6.11,NA,6.11,,2.31,22.13,22.13,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76838780,,Remove abdomen lymph nodes,A,,17.26,8.48,NA,8.48,,3.57,29.31,29.31,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76938790,,Inject for lymphatic x-ray,A,,1.26,0.81,NA,0.81,,0.20,2.27,2.27,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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