Billing code 38564: Node dissectionMedicare rate & RVUs in Alaska
Reports a limited open removal of retroperitoneal lymph nodes for staging or treatment when the operative field and extent support this service.
CMS doesn’t publish an office rate for 38564 in Alaska.
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 38564 covers
This service involves open surgical removal of a limited amount of lymph-node tissue from the retroperitoneum. It is typically performed by a surgeon during an abdominal operation for cancer staging or treatment; retroperitoneal nodal surgery may be part of care for testicular or other abdominal and pelvic malignancies. The operative report should establish the open approach, the retroperitoneal location, and the limited extent of the dissection.
Select this code for the documented procedure rather than a superficial-node biopsy, laparoscopic sampling, or a more extensive dissection. Medicare 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 are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
38564 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $824.26 |
How the 38564 rate is calculated
Each of 38564’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 · 38564
RVUs × geographic indexes × conversion factor
Work11.10
11.10 RVUs× 1.000 GPCI
Practice expense6.26
6.26 RVUs× 1.000 GPCI
Malpractice2.47
2.47 RVUs× 1.000 GPCI
Adjusted RVUs
19.8300
Conversion factor
$33.4009
Medicare rate
$662.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38564
38564 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 38564
Node dissection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.73/0.16 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 38564
Node dissection
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
38564 without 51 · national facility
$662.34
Node dissection
38564-51 · Second procedure: 50%
$331.17
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%).
38564 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 38562Pelvic lymphadenectomy
- This code covers limited open retroperitoneal node removal. Code 38562 is for limited pelvic lymphadenectomy, so choose according to the documented nodal region.
- 38570Laparoscopic node biopsy
- Code 38570 describes laparoscopic retroperitoneal node sampling. Use 38564 for a limited open dissection, not laparoscopic sampling.
- 38571Pelvic lymphadenectomy
- Code 38571 describes laparoscopic bilateral total pelvic lymphadenectomy. It differs from this code in both approach and nodal field.
- 38572Laparoscopic lymphadenectomy
- Code 38572 represents laparoscopic pelvic lymphadenectomy with para-aortic nodal work. Code 38564 is for a limited open retroperitoneal dissection.
38564 billing questions
How does this differ from code 38562?
Code 38564 is for limited open retroperitoneal node removal. Code 38562 describes limited pelvic lymphadenectomy, so the documented nodal field distinguishes them.
When would a laparoscopic code be more appropriate?
Use the applicable laparoscopic code when the nodal procedure is performed laparoscopically. Code 38564 represents an open retroperitoneal dissection.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What documentation supports reporting 38564?
The operative report should identify the open approach, retroperitoneal nodal location, and limited extent of removal, along with the clinical indication.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery 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 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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