Billing code 39401: MediastinoscopyMedicare rate & RVUs in Iowa
Report mediastinoscopy with biopsy when a surgeon uses a mediastinoscope to sample a mediastinal mass or tissue rather than mediastinal lymph nodes.
CMS doesn’t publish an office rate for 39401 in Iowa.
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 39401 covers
A thoracic surgeon typically performs this procedure in an operating room, advancing a mediastinoscope through an incision at the base of the neck to reach and biopsy a mediastinal mass or other mediastinal tissue. The approach provides access to tissue behind the sternum for diagnostic evaluation, including in patients being assessed for a mediastinal lesion. The biopsy is part of the reported service.
Choose this code for mediastinal tissue or mass biopsy; use the lymph-node biopsy code when the sampled targets are mediastinal lymph nodes. The operative report should identify the mediastinal target and document the scope-guided biopsy. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are 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.
39401 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | Unavailable | $259.93 |
How the 39401 rate is calculated
Each of 39401’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 · 39401
RVUs × geographic indexes × conversion factor
Work5.30
5.30 RVUs× 1.000 GPCI
Practice expense2.14
2.14 RVUs× 1.000 GPCI
Malpractice1.32
1.32 RVUs× 1.000 GPCI
Adjusted RVUs
8.7600
Conversion factor
$33.4009
Medicare rate
$292.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 39401
The CMS indicators that decide how 39401 is paid alongside other services.
CMS payment indicators · 39401
Mediastinoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
39401 without 51 · national facility
$292.59
Mediastinoscopy
39401-51 · Second procedure: 50%
$146.30
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
39401 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 39402Mediastinoscopy
- The target determines the choice: 39401 is for mediastinal mass or tissue biopsy, while 39402 is for mediastinal lymph-node biopsy.
- 32606Thoracoscopy biopsy
- Both can involve mediastinal biopsy, but 32606 describes a thoracoscopic diagnostic approach; 39401 describes mediastinoscopy.
- 39499Unlisted px mediastinum
- Use 39499 only when the mediastinal procedure performed is not represented by a specific listed code such as 39401.
39401 billing questions
When should 39401 be chosen instead of 39402?
Use 39401 when the mediastinoscopy biopsy targets a mediastinal mass or other mediastinal tissue. Use 39402 when the sampled targets are mediastinal lymph nodes.
Is the biopsy separately reported from the mediastinoscopy?
No. The biopsy is included in the mediastinoscopy service described by this code.
What care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this procedure.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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