No office rate
Use 38760 for superficial inguinofemoral node removal without pelvic lymphadenectomy. Choose 38765 when the operation includes both groin and pelvic nodes.
On this page
CMS RVU26D · Effective 2026-10-01
38765 Groin lymphadenectomy Medicare reimbursement rates in Hawaii
Reports surgical removal of inguinofemoral nodes together with pelvic nodes, such as for selected cancers with regional nodal disease. Compare 38765 office and facility rates across CMS payment localities in Hawaii.
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 38765 in Hawaii?
Hawaii 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
$1205.61
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 38765: Inguinofemoral and pelvic lymphadenectomy
Reports surgical removal of inguinofemoral nodes together with pelvic nodes, such as for selected cancers with regional nodal disease.
This operation removes lymph nodes in the groin and pelvis as a combined regional dissection. Surgical oncologists, gynecologic oncologists, or urologists may perform it in an operating room for cancers that spread to these nodal areas, including vulvar or penile cancer and melanoma. The code distinguishes this combined operation from groin-only or pelvic-only node removal.
Report the service when the operative documentation supports both inguinofemoral and pelvic lymph node dissection; document the sites treated and the extent of the operation. The pelvic dissection is included in this combined service, so do not separately report pelvic lymphadenectomy for the same work. CMS 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 38765
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.36 · 58%
- Practice expense (office) RVU10.50 · 29%
- Malpractice RVU4.83 · 13%
101
Medicare services in 2024 · #4877 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.
38765 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This code is for pelvic lymphadenectomy alone. The combined groin and pelvic dissection is reported with 38765, not as separate pelvic work.
No office rate
Code 38531 describes open biopsy or excision of inguinofemoral node(s) for limited sampling; 38765 represents a regional dissection that also includes pelvic nodes.
Compare 38765 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
$1205.61
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 38765 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,766
- Code
- 38765
- Physician work
- 21.36
- Practice expense
- 10.50
- Malpractice
- 4.83
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.36 | × 1.000 | 21.3600 |
| Practice expense | 10.50 | × 1.137 | 11.9385 |
| Malpractice | 4.83 | × 0.579 | 2.7966 |
| Total RVUs | 36.0951 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1205.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.36 | 1 |
| Practice expense | 10.5 | 1.137 |
| Malpractice | 4.83 | 0.579 |
(21.36 × 1 + 10.5 × 1.137 + 4.83 × 0.579) × $33.4009 = $1205.61
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.
38765 billing questions
How does this differ from 38760?
This code covers groin dissection together with pelvic lymphadenectomy. Code 38760 is for superficial inguinofemoral lymphadenectomy without the pelvic dissection.
Can 38770 be reported separately for the pelvic portion?
Do not separately report 38770 for pelvic node removal included in the combined operation. Use 38770 when the service is pelvic lymphadenectomy without the inguinofemoral dissection.
What documentation supports reporting this code?
The operative report should identify both the inguinofemoral and pelvic nodal regions dissected and describe the procedure performed at each site.
How is bilateral surgery reported?
For bilateral performance, report modifier 50; CMS payment for this bilateral procedure is 150%.
Are assistant or co-surgeon services payable?
CMS permits payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,76338746,,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
4,76838780,,Remove abdomen lymph nodes,A,,17.26,8.48,NA,8.48,,3.57,29.31,29.31,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76938790,,Inject for lymphatic x-ray,A,,1.26,0.81,NA,0.81,,0.20,2.27,2.27,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,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