Billing code 38765: Groin lymphadenectomyMedicare rate & RVUs in Illinois
Reports surgical removal of inguinofemoral nodes together with pelvic nodes, such as for selected cancers with regional nodal disease.
CMS doesn’t publish an office rate for 38765 in Illinois.
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 38765 covers
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.
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.
Where 38765 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,441.14 |
| East St. Louis | Unavailable | $1,361.01 |
| Rest Of Illinois | Unavailable | $1,285.79 |
| Suburban Chicago | Unavailable | $1,364.49 |
How the 38765 rate is calculated
Each of 38765’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 · 38765
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.36Practice expense 10.50Malpractice 4.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 38765
38765 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 38765
Groin lymphadenectomy
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 38765
Groin lymphadenectomy
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 50 · payment effect
With and without the modifier
38765 without 50 · national facility
$1,225.48
Groin lymphadenectomy
38765-50 · Bilateral: 150%
$1,838.22
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
38765 compared with similar codes
Compare codes
38765 vs 38760 vs 38770 vs 38531: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 38760Groin lymphadenectomy
- Use 38760 for superficial inguinofemoral node removal without pelvic lymphadenectomy. Choose 38765 when the operation includes both groin and pelvic nodes.
- 38770Pelvic lymphadenectomy
- This code is for pelvic lymphadenectomy alone. The combined groin and pelvic dissection is reported with 38765, not as separate pelvic work.
- 38531Groin node surgery
- Code 38531 describes open biopsy or excision of inguinofemoral node(s) for limited sampling; 38765 represents a regional dissection that also includes pelvic nodes.
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 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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