No office rate
Use 39560 for diaphragm resection followed by simple repair. Use 39561 when the defect needs complex reconstruction, such as graft repair.
On this page
CMS RVU26D · Effective 2026-10-01
39561 in Salinas
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1224.89
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.
Thoracic surgery
About 39561: Complex diaphragm resection and reconstruction
Report 39561 when diaphragm tissue is removed and the resulting defect requires complex reconstruction, such as closure with a graft.
Code 39561 describes removal of diaphragm tissue followed by complex repair of the defect, such as reconstruction using a graft. It is most often encountered during a major operation when a tumor or other diseased tissue involves the diaphragm. Thoracic or abdominal surgeons typically perform the work in a hospital operating room. The complex reconstruction distinguishes this service from a resection that can be repaired simply.
Choose this code when the operative report supports both diaphragm resection and complex repair; document the resection and how the defect was reconstructed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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 code's descriptor and anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 39561
- 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 RVU19.49 · 53%
- Practice expense (office) RVU12.01 · 33%
- Malpractice RVU4.96 · 14%
127
Medicare services in 2024 · #4690 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.
39561 compared with similar codes
Office rates for Salinas, from the same CMS release.
No office rate
39501 addresses repair of a diaphragm laceration. It does not describe resection followed by complex reconstruction.
No office rate
39540 is for repair of an acute traumatic diaphragmatic hernia. Choose 39561 when diaphragm tissue is resected and the defect receives complex repair.
The same code, a different location
How does Salinas compare?
39561 across payment areas
Same release and payment basis · bars start at $0
Salinas · 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
Madera
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Merced
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Modesto
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Napa
California · 39561
Office
Unavailable
Facility
$1304.86
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 39561
Office
Unavailable
Facility
$1246.58
No comparable office rate is available.
Redding
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Rest Of California
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 39561
Office
Unavailable
Facility
$1243.67
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 39561
Office
Unavailable
Facility
$1229.75
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 39561
Office
Unavailable
Facility
$1240.07
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 39561
Office
Unavailable
Facility
$1354.48
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 39561
Office
Unavailable
Facility
$1348.85
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 39561
Office
Unavailable
Facility
$1389.84
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 39561
Office
Unavailable
Facility
$1366.81
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 39561
Office
Unavailable
Facility
$1207.75
No comparable office rate is available.
Santa Cruz-Watsonville
California · 39561
Office
Unavailable
Facility
$1240.84
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 39561
Office
Unavailable
Facility
$1225.74
No comparable office rate is available.
Santa Rosa-Petaluma
California · 39561
Office
Unavailable
Facility
$1251.92
No comparable office rate is available.
Stockton
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Vallejo
California · 39561
Office
Unavailable
Facility
$1296.75
No comparable office rate is available.
Visalia
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Yuba City
California · 39561
Office
Unavailable
Facility
$1190.50
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 39561
Office
Unavailable
Facility
$1343.07
No comparable office rate is available.
Miami
Florida · 39561
Office
Unavailable
Facility
$1487.55
No comparable office rate is available.
Chicago
Illinois · 39561
Office
Unavailable
Facility
$1438.90
No comparable office rate is available.
Manhattan
New York · 39561
Office
Unavailable
Facility
$1421.53
No comparable office rate is available.
Alaska*
Alaska · 39561
Office
Unavailable
Facility
$1494.98
No comparable office rate is available.
Alabama
Alabama · 39561
Office
Unavailable
Facility
$1095.75
No comparable office rate is available.
Arkansas
Arkansas · 39561
Office
Unavailable
Facility
$1080.89
No comparable office rate is available.
Arizona
Arizona · 39561
Office
Unavailable
Facility
$1181.51
No comparable office rate is available.
Colorado
Colorado · 39561
Office
Unavailable
Facility
$1215.00
No comparable office rate is available.
Connecticut
Connecticut · 39561
Office
Unavailable
Facility
$1296.50
No comparable office rate is available.
Delaware
Delaware · 39561
Office
Unavailable
Facility
$1199.51
No comparable office rate is available.
Fort Lauderdale
Florida · 39561
Office
Unavailable
Facility
$1356.87
No comparable office rate is available.
Rest Of Florida
Florida · 39561
Office
Unavailable
Facility
$1283.48
No comparable office rate is available.
Atlanta
Georgia · 39561
Office
Unavailable
Facility
$1259.47
No comparable office rate is available.
Rest Of Georgia
Georgia · 39561
Office
Unavailable
Facility
$1206.28
No comparable office rate is available.
Hawaii, Guam
Hawaii · 39561
Office
Unavailable
Facility
$1203.01
No comparable office rate is available.
Iowa
Iowa · 39561
Office
Unavailable
Facility
$1083.80
No comparable office rate is available.
Idaho
Idaho · 39561
Office
Unavailable
Facility
$1098.40
No comparable office rate is available.
East St. Louis
Illinois · 39561
Office
Unavailable
Facility
$1353.69
No comparable office rate is available.
Rest Of Illinois
Illinois · 39561
Office
Unavailable
Facility
$1276.17
No comparable office rate is available.
Suburban Chicago
Illinois · 39561
Office
Unavailable
Facility
$1361.08
No comparable office rate is available.
Indiana
Indiana · 39561
Office
Unavailable
Facility
$1103.36
No comparable office rate is available.
Kansas
Kansas · 39561
Office
Unavailable
Facility
$1097.12
No comparable office rate is available.
Kentucky
Kentucky · 39561
Office
Unavailable
Facility
$1159.19
No comparable office rate is available.
New Orleans
Louisiana · 39561
Office
Unavailable
Facility
$1216.66
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 39561
Office
Unavailable
Facility
$1164.71
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 39561
Office
Unavailable
Facility
$1304.09
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 39561
Office
Unavailable
Facility
$1215.84
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 39561
Office
Unavailable
Facility
$1296.76
No comparable office rate is available.
Rest Of Maryland
Maryland · 39561
Office
Unavailable
Facility
$1215.54
No comparable office rate is available.
Rest Of Maine
Maine · 39561
Office
Unavailable
Facility
$1123.08
No comparable office rate is available.
Southern Maine
Maine · 39561
Office
Unavailable
Facility
$1153.05
No comparable office rate is available.
Detroit
Michigan · 39561
Office
Unavailable
Facility
$1317.41
No comparable office rate is available.
Rest Of Michigan
Michigan · 39561
Office
Unavailable
Facility
$1204.27
No comparable office rate is available.
Minnesota
Minnesota · 39561
Office
Unavailable
Facility
$1112.80
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 39561
Office
Unavailable
Facility
$1189.52
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 39561
Office
Unavailable
Facility
$1198.87
No comparable office rate is available.
Rest Of Missouri
Missouri · 39561
Office
Unavailable
Facility
$1158.13
No comparable office rate is available.
Mississippi
Mississippi · 39561
Office
Unavailable
Facility
$1118.80
No comparable office rate is available.
Montana**
Montana · 39561
Office
Unavailable
Facility
$1217.47
No comparable office rate is available.
North Carolina
North Carolina · 39561
Office
Unavailable
Facility
$1131.11
No comparable office rate is available.
North Dakota**
North Dakota · 39561
Office
Unavailable
Facility
$1119.39
No comparable office rate is available.
Nebraska
Nebraska · 39561
Office
Unavailable
Facility
$1083.86
No comparable office rate is available.
New Hampshire
New Hampshire · 39561
Office
Unavailable
Facility
$1213.54
No comparable office rate is available.
Northern Nj
New Jersey · 39561
Office
Unavailable
Facility
$1334.26
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 39561
Office
Unavailable
Facility
$1296.81
No comparable office rate is available.
New Mexico
New Mexico · 39561
Office
Unavailable
Facility
$1217.80
No comparable office rate is available.
Nevada**
Nevada · 39561
Office
Unavailable
Facility
$1190.53
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 39561
Office
Unavailable
Facility
$1477.25
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 39561
Office
Unavailable
Facility
$1319.99
No comparable office rate is available.
Queens
New York · 39561
Office
Unavailable
Facility
$1405.69
No comparable office rate is available.
Rest Of New York
New York · 39561
Office
Unavailable
Facility
$1148.54
No comparable office rate is available.
Ohio
Ohio · 39561
Office
Unavailable
Facility
$1184.22
No comparable office rate is available.
Oklahoma
Oklahoma · 39561
Office
Unavailable
Facility
$1137.93
No comparable office rate is available.
Portland
Oregon · 39561
Office
Unavailable
Facility
$1230.33
No comparable office rate is available.
Rest Of Oregon
Oregon · 39561
Office
Unavailable
Facility
$1166.99
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 39561
Office
Unavailable
Facility
$1277.94
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 39561
Office
Unavailable
Facility
$1175.79
No comparable office rate is available.
Puerto Rico
Puerto Rico · 39561
Office
Unavailable
Facility
$1219.72
No comparable office rate is available.
Rhode Island
Rhode Island · 39561
Office
Unavailable
Facility
$1225.51
No comparable office rate is available.
South Carolina
South Carolina · 39561
Office
Unavailable
Facility
$1162.46
No comparable office rate is available.
South Dakota**
South Dakota · 39561
Office
Unavailable
Facility
$1107.79
No comparable office rate is available.
Tennessee
Tennessee · 39561
Office
Unavailable
Facility
$1104.59
No comparable office rate is available.
Austin
Texas · 39561
Office
Unavailable
Facility
$1223.48
No comparable office rate is available.
Beaumont
Texas · 39561
Office
Unavailable
Facility
$1169.93
No comparable office rate is available.
Brazoria
Texas · 39561
Office
Unavailable
Facility
$1182.95
No comparable office rate is available.
Dallas
Texas · 39561
Office
Unavailable
Facility
$1198.53
No comparable office rate is available.
Fort Worth
Texas · 39561
Office
Unavailable
Facility
$1196.67
No comparable office rate is available.
Galveston
Texas · 39561
Office
Unavailable
Facility
$1191.70
No comparable office rate is available.
Houston
Texas · 39561
Office
Unavailable
Facility
$1282.49
No comparable office rate is available.
Rest Of Texas
Texas · 39561
Office
Unavailable
Facility
$1181.27
No comparable office rate is available.
Utah
Utah · 39561
Office
Unavailable
Facility
$1176.83
No comparable office rate is available.
Virginia
Virginia · 39561
Office
Unavailable
Facility
$1162.27
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 39561
Office
Unavailable
Facility
$1219.72
No comparable office rate is available.
Vermont
Vermont · 39561
Office
Unavailable
Facility
$1131.95
No comparable office rate is available.
Rest Of Washington
Washington · 39561
Office
Unavailable
Facility
$1207.93
No comparable office rate is available.
Seattle (King Cnty)
Washington · 39561
Office
Unavailable
Facility
$1311.09
No comparable office rate is available.
Wisconsin
Wisconsin · 39561
Office
Unavailable
Facility
$1086.31
No comparable office rate is available.
West Virginia
West Virginia · 39561
Office
Unavailable
Facility
$1236.65
No comparable office rate is available.
Wyoming**
Wyoming · 39561
Office
Unavailable
Facility
$1174.72
No comparable office rate is available.
See how rates vary across the country
39561 · 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?
Salinas is a Medicare payment area. Our Census mapping connects it to 30 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 39561 in Salinas. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1347.38
$1224.89 × 110% = $1347.38
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 39561 in Salinas.
PPRRVU2026_Oct_nonQPP.csv
4,787
- Code
- 39561
- Physician work
- 19.49
- Practice expense
- 12.01
- Malpractice
- 4.96
GPCI2026.csv
22
- Locality
- Salinas
- Physician work
- 1.031
- Practice expense
- 1.159
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.49 | × 1.031 | 20.0942 |
| Practice expense | 12.01 | × 1.159 | 13.9196 |
| Malpractice | 4.96 | × 0.536 | 2.6586 |
| Total RVUs | 36.6723 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Salinas$1224.89
Open 39561 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.49 | 1.031 |
| Practice expense | 12.01 | 1.159 |
| Malpractice | 4.96 | 0.536 |
(19.49 × 1.031 + 12.01 × 1.159 + 4.96 × 0.536) × $33.4009 = $1224.89
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
39561 · 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 | $1224.89 | RVU26D |
| 2026-07-01 | Not available in this setting | $1224.89 | RVU26C |
| 2026-04-01 | Not available in this setting | $1224.89 | RVU26B |
| 2026-01-01 | Not available in this setting | $1224.89 | RVU26A |
| 2025-10-01 | Not available in this setting | $1247.58 | RVU25D |
| 2025-07-01 | Not available in this setting | $1247.58 | RVU25C |
| 2025-04-01 | Not available in this setting | $1247.58 | RVU25B |
| 2025-01-01 | Not available in this setting | $1247.58 | RVU25A |
39561 billing questions
How does 39561 differ from 39560?
Both describe diaphragm resection. Use 39561 when the defect requires complex repair, such as graft reconstruction; 39560 is for a simple repair.
Is the repair or graft separately reported?
The complex repair of the defect created by the diaphragm resection is included in 39561. Document the reconstruction technique in the operative report.
Can modifier 50 be used when both sides are involved?
No. The descriptor and anatomy make modifier 50 inappropriate for this service.
What supports reporting 39561 rather than a diaphragm repair code?
The operative report should establish that diaphragm tissue was resected and that the resulting defect required complex reconstruction. A traumatic tear or hernia repair without this resection is a different service.
What are the global and multiple-procedure payment rules?
The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
When may an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team-surgery payment is 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.
4,78439541,,Repair of diaphragm hernia,A,,15.36,7.25,NA,7.25,,3.98,26.59,26.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78539545,,Revision of diaphragm,A,,14.30,8.24,NA,8.24,,3.59,26.13,26.13,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78639560,,Resect diaphragm simple,A,,12.73,6.96,NA,6.96,,3.03,22.72,22.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78739561,,Resect diaphragm complex,A,,19.49,12.01,NA,12.01,,4.96,36.46,36.46,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78839599,,Unlisted px diaphragm,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
4,7894000F,,Tobacco use txmnt counseling,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,7904001F,,Tobacco use txmnt pharmacol,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1901112,CA,61,REDDING,1.017,1.096,0.536
2001112,CA,62,RIVERSIDE-SAN BERNARDINO-ONTARIO,1.018,1.096,0.853
2101112,CA,63,SACRAMENTO-ROSEVILLE-FOLSOM,1.036,1.163,0.536
2201112,CA,64,SALINAS,1.031,1.159,0.536
2301182,CA,72,SAN DIEGO-CHULA VISTA-CARLSBAD,1.030,1.196,0.542
2401112,CA,05,SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY),1.095,1.410,0.425
2501112,CA,52,SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY),1.095,1.410,0.459