Billing code 38510: Lymph node biopsyMedicare rate & RVUs in Alabama

Reports open biopsy or excision of deep cervical lymph nodes when a surgeon obtains nodal tissue for diagnosis, such as evaluating suspected lymphoma or metastatic disease.

CMS RVU26DEffective Oct 1, 20261 payment locality6.7K Medicare services in 2024

Medicare pays $496.55 for 38510 in the office in Alabama (Alabama). Which amount applies depends on the service address.

$496.55Office (non-facility)
$345.16Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 38510 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alabama
  2. What 38510 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 38510 covers

This code covers an open surgical biopsy or removal of one or more deep cervical lymph nodes, commonly from the deep neck chain. An otolaryngologist, head and neck surgeon, or general surgeon may perform it when imaging or examination identifies a node requiring tissue diagnosis, including workup for suspected lymphoma or metastatic cancer. The node is submitted for pathologic examination; this is different from sampling a superficial neck node or using a needle approach.

Report the code for the open deep cervical procedure, documenting the node’s location, the operative approach, and whether biopsy or excision was performed. The 10-day global period includes related postoperative visits during that period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. For bilateral work, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

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.

38510 in Alabama

38510 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$496.55$345.16

How the 38510 rate is calculated

Each of 38510’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 38510

RVUs × geographic indexes × conversion factor

Work6.57

6.57 RVUs× 1.000 GPCI

Practice expense8.66

8.66 RVUs× 1.000 GPCI

Malpractice1.27

1.27 RVUs× 1.000 GPCI

Adjusted RVUs

16.5000

Conversion factor

$33.4009

Medicare rate

$551.11

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 38510

38510 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38510

Lymph node biopsy

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 38510

Lymph node biopsy

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

38510 without 50 · national office

$551.11

Lymph node biopsy

38510-50 · Bilateral: 150%

$826.67

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

38510 compared with similar codes

Compare codes · National

5 codes, side by side

  • 38510

    Lymph node biopsy6.57 wRVU

    $551.11

  • 38500

    Lymph node biopsy3.7 wRVU

    $369.41−$181.70

  • 38505

    Lymph node biopsy1.55 wRVU

    $170.34−$380.77

  • 38520

    Lymph node biopsy6.85 wRVU

    Not priced

  • 38525

    Axillary node biopsy6.27 wRVU

    Not priced

How to choose

38500Lymph node biopsy
Choose 38510 for open sampling or removal of deep cervical nodes; 38500 is for superficial lymph nodes.
38505Lymph node biopsy
Choose 38505 for percutaneous needle sampling. The open surgical approach to a deep cervical node is reported with 38510.
38520Lymph node biopsy
38520 includes the scalene fat pad with open deep cervical node work. Use 38510 when that tissue is not included.
38525Axillary node biopsy
Both describe open nodal procedures, but 38525 is for deep axillary nodes; 38510 is for deep cervical nodes.

38510 billing questions

How does this differ from 38500?

38510 is for open work on deep cervical nodes. Code 38500 applies to open biopsy or excision of superficial lymph nodes.

Can 38510 be used for a needle biopsy?

No. For percutaneous needle sampling of a lymph node, consider 38505; 38510 describes an open surgical approach to deep cervical nodes.

When is 38520 more appropriate?

38520 describes open deep cervical node work that includes the scalene fat pad. Use 38510 when that additional tissue is not part of the procedure.

How is bilateral deep cervical work reported?

The CMS payment rule identifies modifier 50 for bilateral procedures and pays the procedure at 150%. Document the work on both sides.

Are postoperative visits included?

Related postoperative visits during the 10-day global period are included in the procedure’s payment.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 38510. Co-surgeons and team surgery are not permitted under the listed CMS rules.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 38510PPRRVU2026_Oct_nonQPP.csv, line 4,743 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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