No office rate
Both codes concern cystic hygroma excision, but 38555 is for the mediastinum; this code is for the cervical or axillary region.
On this page
CMS RVU26D · Effective 2026-10-01
38550 Hygroma excision Medicare reimbursement rates in Delaware
Reports surgical removal of a cystic hygroma in the neck or armpit, such as a congenital lymphatic malformation requiring operative excision. Compare 38550 office and facility rates across CMS payment localities in Delaware.
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.
What does Medicare pay for 38550 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$509.94
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Lymphatic surgery
About 38550: Cervical or axillary cystic hygroma excision
Reports surgical removal of a cystic hygroma in the neck or armpit, such as a congenital lymphatic malformation requiring operative excision.
This code describes surgical excision of a cystic hygroma, a lymphatic malformation, in the cervical or axillary region. A surgeon may perform the operation in a hospital or ambulatory surgical setting, often for a congenital lesion that is enlarging, symptomatic, or affecting nearby structures. The target is the malformation itself, not a lymph node removed for diagnostic sampling or nodal dissection.
Report the code when the operative record supports excision of a cervical or axillary cystic hygroma and identifies the site and extent of removal. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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 under the CMS bilateral rule for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 38550
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.93 · 45%
- Practice expense (office) RVU6.72 · 43%
- Malpractice RVU1.85 · 12%
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.
38550 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
38520 describes excision of deep cervical lymph nodes. Choose this code only when the operative target is nodal tissue rather than a cystic hygroma.
$364.41
38500 is for biopsy or excision of superficial lymph nodes. It does not describe removal of a cervical or axillary cystic hygroma.
Compare 38550 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$509.94
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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 38550 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,749
- Code
- 38550
- Physician work
- 6.93
- Practice expense
- 6.72
- Malpractice
- 1.85
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.93 | × 1.005 | 6.9646 |
| Practice expense | 6.72 | × 0.988 | 6.6394 |
| Malpractice | 1.85 | × 0.899 | 1.6632 |
| Total RVUs | 15.2672 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$509.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.93 | 1.005 |
| Practice expense | 6.72 | 0.988 |
| Malpractice | 1.85 | 0.899 |
(6.93 × 1.005 + 6.72 × 0.988 + 1.85 × 0.899) × $33.4009 = $509.94
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.
38550 billing questions
How does this differ from lymph node excision codes?
Use this code for excision of a cervical or axillary cystic hygroma. Codes such as 38500 or 38520 describe lymph node procedures, not removal of a lymphatic malformation.
When would 38555 be reported instead?
38555 is for excision of a mediastinal cystic hygroma. This code is for a cervical or axillary site.
Can modifier 50 be appended for lesions on both sides?
CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.
What documentation supports reporting this code?
The operative report should identify the lesion as a cystic hygroma, document its cervical or axillary location, and describe the excision performed.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
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.
4,74638530,,Biopsy/removal lymph nodes,A,,8.13,6.04,NA,6.04,,1.72,15.89,15.89,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74738531,,Open bx/exc inguinofem nodes,A,,6.57,4.75,NA,4.75,,1.63,12.95,12.95,0,090,0.11,0.73,0.16,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74838542,,Explore deep node(s) neck,A,,7.75,4.98,NA,4.98,,1.33,14.06,14.06,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74938550,,Removal neck/armpit lesion,A,,6.93,6.72,NA,6.72,,1.85,15.50,15.50,0,090,0.11,0.73,0.16,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,75038555,,Removal neck/armpit lesion,A,,15.20,10.18,NA,10.18,,4.06,29.44,29.44,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,75138562,,Removal pelvic lymph nodes,A,,10.78,7.02,NA,7.02,,2.25,20.05,20.05,0,090,0.11,0.73,0.16,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,75238564,,Removal abdomen lymph nodes,A,,11.10,6.26,NA,6.26,,2.47,19.83,19.83,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503