No office rate
Choose 39402 for mediastinoscopic sampling of lymph nodes. Code 39401 is associated with mediastinal biopsy that is not described as lymph node biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
39402 Mediastinoscopy Medicare reimbursement rates in Hawaii
Report this service when a surgeon uses mediastinoscopy to obtain mediastinal lymph node tissue, commonly for lung cancer staging or diagnostic evaluation. Compare 39402 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 39402 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
$364.36
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.
Thoracic surgery
About 39402: Mediastinoscopic mediastinal lymph node biopsy
Report this service when a surgeon uses mediastinoscopy to obtain mediastinal lymph node tissue, commonly for lung cancer staging or diagnostic evaluation.
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.
CMS billing rules for 39402
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.07 · 63%
- Practice expense (office) RVU2.48 · 22%
- Malpractice RVU1.76 · 16%
1.3K
Medicare services in 2024 · #2771 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.
39402 compared with similar codes
Office rates for Hawaii, from the same CMS release.
39499
No office rateUnlisted 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.
No office rate
Code 32606 describes diagnostic thoracoscopy with mediastinal tissue biopsy; 39402 describes lymph node sampling by mediastinoscopy.
Compare 39402 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
$364.36
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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 39402 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,779
- Code
- 39402
- Physician work
- 7.07
- Practice expense
- 2.48
- Malpractice
- 1.76
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.07 | × 1.000 | 7.0700 |
| Practice expense | 2.48 | × 1.137 | 2.8198 |
| Malpractice | 1.76 | × 0.579 | 1.0190 |
| Total RVUs | 10.9088 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$364.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.07 | 1 |
| Practice expense | 2.48 | 1.137 |
| Malpractice | 1.76 | 0.579 |
(7.07 × 1 + 2.48 × 1.137 + 1.76 × 0.579) × $33.4009 = $364.36
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.
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 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.
4,77639200,,Resect mediastinal cyst,A,,14.71,6.49,NA,6.49,,3.70,24.90,24.90,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,77739220,,Resect mediastinal tumor,A,,19.06,8.47,NA,8.47,,4.44,31.97,31.97,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,77839401,,Mediastinoscpy w/medstnl bx,A,,5.30,2.14,NA,2.14,,1.32,8.76,8.76,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,77939402,,Mediastinoscpy w/lmph nod bx,A,,7.07,2.48,NA,2.48,,1.76,11.31,11.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78039499,,Unlisted px mediastinum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78139501,,Repair diaphragm laceration,A,,13.63,7.31,NA,7.31,,3.31,24.25,24.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78239503,,Repair of diaphragm hernia,A,,106.19,27.29,NA,27.29,,26.77,160.25,160.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,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