No office rate
Choose 38747 for regional abdominal nodal removal. 38780 describes a more extensive transabdominal retroperitoneal dissection that includes pelvic, para-aortic, and iliac nodes.
On this page
CMS RVU26D · Effective 2026-10-01
38747 Abdominal lymphadenectomy Medicare reimbursement rates in Guam
Reports regional removal of abdominal lymph nodes, such as celiac, superior mesenteric, and para-aortic nodes, as an add-on to a primary operation. Compare 38747 office and facility rates across CMS payment localities in Guam.
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 38747 in Guam?
Guam 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
$228.33
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 38747: Regional abdominal lymph node dissection
Reports regional removal of abdominal lymph nodes, such as celiac, superior mesenteric, and para-aortic nodes, as an add-on to a primary operation.
This add-on describes regional lymph node removal in the abdomen, including nodes in the celiac, superior mesenteric, and para-aortic areas. A surgeon may perform it during an operation for an abdominal malignancy when nodal tissue is removed for treatment or staging. General surgeons and surgical oncologists commonly perform these dissections; other surgical specialists may do so when treating cancers within their fields.
Report 38747 only with a primary procedure. The operative report should identify the abdominal nodal basin removed and describe the dissection sufficiently to distinguish regional node removal from a more extensive retroperitoneal dissection. CMS pays the add-on within the primary procedure’s global period, so related postoperative care is governed by that primary procedure’s global period. A pelvic-only dissection or a dissection involving broader retroperitoneal and pelvic basins may point to a different code.
CMS billing rules for 38747
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.76 · 66%
- Practice expense (office) RVU1.22 · 17%
- Malpractice RVU1.19 · 17%
1.3K
Medicare services in 2024 · #2781 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.
38747 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
38770 is for pelvic lymphadenectomy, including specified pelvic nodal groups; 38747 is for regional abdominal nodes such as celiac and superior mesenteric nodes.
No office rate
38746 describes regional thoracic lymphadenectomy. Use 38747 when the nodal dissection is in the abdomen.
Compare 38747 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$228.33
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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 38747 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,764
- Code
- 38747
- Physician work
- 4.76
- Practice expense
- 1.22
- Malpractice
- 1.19
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.76 | × 1.000 | 4.7600 |
| Practice expense | 1.22 | × 1.137 | 1.3871 |
| Malpractice | 1.19 | × 0.579 | 0.6890 |
| Total RVUs | 6.8361 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$228.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.76 | 1 |
| Practice expense | 1.22 | 1.137 |
| Malpractice | 1.19 | 0.579 |
(4.76 × 1 + 1.22 × 1.137 + 1.19 × 0.579) × $33.4009 = $228.33
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.
38747 billing questions
Can 38747 be reported by itself?
No. It is an add-on code and must be reported with a primary procedure.
What should the operative note document?
Identify the abdominal nodal basin removed, such as celiac, superior mesenteric, or para-aortic nodes, and describe the extent of the dissection.
How does 38747 differ from 38780?
38747 describes regional abdominal lymph node removal. 38780 is for an extensive transabdominal retroperitoneal dissection that includes pelvic, para-aortic, and iliac nodes.
Does 38747 include pelvic lymph nodes?
It identifies regional abdominal nodes, not a pelvic-only dissection. For pelvic lymphadenectomy, consider 38770 when its service description matches the operation.
How does the global period affect this add-on?
The add-on is reported with a primary procedure, and its payment falls within that procedure’s global period. Related postoperative care is governed by the primary procedure’s global period.
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.
4,76138740,,Remove armpit lymph nodes,A,,10.43,7.06,NA,7.06,,2.68,20.17,20.17,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76238745,,Remove armpit lymph nodes,A,,13.52,8.22,NA,8.22,,3.41,25.15,25.15,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76338746,,Remove thoracic lymph nodes,A,,4.02,0.81,NA,0.81,,1.02,5.85,5.85,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76438747,,Remove abdominal lymph nodes,A,,4.76,1.22,NA,1.22,,1.19,7.17,7.17,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76538760,,Remove groin lymph nodes,A,,13.28,7.16,NA,7.16,,2.93,23.37,23.37,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76638765,,Remove groin lymph nodes,A,,21.36,10.50,NA,10.50,,4.83,36.69,36.69,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76738770,,Remove pelvis lymph nodes,A,,13.71,6.11,NA,6.11,,2.31,22.13,22.13,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014