No office rate
Choose 38745 for a complete axillary dissection; 38740 describes a more limited dissection.
On this page
CMS RVU26D · Effective 2026-10-01
38745 Axillary dissection Medicare reimbursement rates in Iowa
Report this service for a complete axillary lymph node dissection, typically performed to treat or stage breast cancer when broader nodal removal is required. Compare 38745 office and facility rates across CMS payment localities in Iowa.
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 38745 in Iowa?
Iowa 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
$748.02
1 of 1 localities have a supported rate.
Payment area: Iowa
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 38745: Complete axillary lymph node dissection
Report this service for a complete axillary lymph node dissection, typically performed to treat or stage breast cancer when broader nodal removal is required.
A surgeon removes a broad group of lymph nodes from the armpit, most often during breast cancer treatment or staging when the operative plan calls for a complete axillary dissection rather than limited node sampling. The service is generally performed in an operating room by a surgeon, often alongside breast surgery. The operative report should identify the axillary dissection and its extent; a few nodes removed for biopsy or sentinel-node evaluation are not the same service.
Select this code for the complete dissection, not the more limited axillary procedure represented by 38740. When a breast procedure code already includes axillary lymphadenectomy, do not separately report the same dissection. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are reduced. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 38745
- 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 RVU13.52 · 54%
- Practice expense (office) RVU8.22 · 33%
- Malpractice RVU3.41 · 14%
1.4K
Medicare services in 2024 · #2715 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.
38745 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
38525 is for excision or biopsy of deep axillary nodes, not removal of the broader axillary nodal basin.
No office rate
19302 includes partial mastectomy with axillary lymphadenectomy. Do not separately report 38745 for the same included dissection.
No office rate
19307 describes a modified radical mastectomy that includes axillary node removal; 38745 is the separate axillary dissection service.
Compare 38745 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
Iowa →
Office / nonfacility
Unavailable
Facility
$748.02
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 38745 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
4,762
- Code
- 38745
- Physician work
- 13.52
- Practice expense
- 8.22
- Malpractice
- 3.41
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.52 | × 1.000 | 13.5200 |
| Practice expense | 8.22 | × 0.915 | 7.5213 |
| Malpractice | 3.41 | × 0.397 | 1.3538 |
| Total RVUs | 22.3951 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$748.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.52 | 1 |
| Practice expense | 8.22 | 0.915 |
| Malpractice | 3.41 | 0.397 |
(13.52 × 1 + 8.22 × 0.915 + 3.41 × 0.397) × $33.4009 = $748.02
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.
38745 billing questions
How does this differ from 38740?
38745 represents a complete axillary dissection. Use 38740 for the more limited axillary lymphadenectomy.
Can this be reported with a breast operation?
It may be performed during breast cancer surgery, but do not separately report the dissection when the breast procedure code already includes axillary lymphadenectomy. For example, 19302 includes partial mastectomy with axillary lymphadenectomy.
Can I report this for a few removed nodes?
No. A limited biopsy or excision of deep axillary nodes is distinct from a complete dissection; 38525 may describe deep-node sampling instead.
How is bilateral surgery reported?
Use modifier 50 for bilateral performance. CMS pays the bilateral procedure at 150%.
What documentation supports 38745?
The operative report should establish that the surgeon performed a complete axillary dissection, rather than limited node sampling, and identify the side or sides treated.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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.
4,75938720,,Removal of lymph nodes neck,A,,21.40,10.57,NA,10.57,,3.81,35.78,35.78,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76038724,,Removal of lymph nodes neck,A,,23.35,10.76,NA,10.76,,3.69,37.80,37.80,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,76138740,,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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136