Billing code 39402: MediastinoscopyMedicare rate & RVUs in Alabama
Report this service when a surgeon uses mediastinoscopy to obtain mediastinal lymph node tissue, commonly for lung cancer staging or diagnostic evaluation.
CMS doesn’t publish an office rate for 39402 in Alabama.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 39402 covers
A thoracic surgeon advances a mediastinoscope through an incision at the base of the neck to reach mediastinal lymph nodes and obtain tissue for pathology. A common use is sampling nodes to stage lung cancer; mediastinal lymphadenopathy or suspected lymphoma may also prompt tissue diagnosis. The service is typically performed in a hospital operating room under anesthesia.
Report the code when lymph node tissue is sampled through the mediastinoscopic approach; the biopsy is part of the service, rather than a separate biopsy charge for those nodes. The operative report should identify the approach and sampled nodal sites. The 0-day global period includes same-day preoperative and postoperative care. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and 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.
39402 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $341.90 |
How the 39402 rate is calculated
Each of 39402’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 · 39402
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.07Practice expense 2.48Malpractice 1.76
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 39402
The CMS indicators that decide how 39402 is paid alongside other services.
CMS payment indicators · 39402
Mediastinoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
39402 without 51 · national facility
$377.76
Mediastinoscopy
39402-51 · Second procedure: 50%
$188.88
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
39402 compared with similar codes
Compare codes
39402 vs 39401 vs 39499 vs 32606: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 39401Mediastinoscopy
- Choose 39402 for mediastinoscopic sampling of lymph nodes. Code 39401 is associated with mediastinal biopsy that is not described as lymph node biopsy.
- 39499Unlisted px mediastinum
- Use 39402 when the service is mediastinoscopic lymph node biopsy. The unlisted code is for a mediastinal procedure that lacks a specific listed code.
- 32606Thoracoscopy biopsy
- Code 32606 describes diagnostic thoracoscopy with mediastinal tissue biopsy; 39402 describes lymph node sampling by mediastinoscopy.
39402 billing questions
How is this distinguished from 39401?
Use 39402 when mediastinoscopy is used to biopsy mediastinal lymph nodes. Code 39401 is associated with mediastinal biopsy rather than lymph node biopsy.
Can the sampled lymph node biopsy be billed separately?
No. The lymph node sampling is included in the mediastinoscopic service; do not report a separate biopsy charge for tissue obtained through this procedure.
What documentation supports reporting 39402?
The operative report should establish the mediastinoscopic approach and identify the mediastinal lymph node sites sampled.
Should modifier 50 be appended when nodes on both sides are sampled?
No. Modifier 50 is inappropriate for this code, even when the operative report describes sampling on both sides.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 39402. Co-surgeons and team surgery are 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 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
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