No office rate
This code covers limited open retroperitoneal node removal. Code 38562 is for limited pelvic lymphadenectomy, so choose according to the documented nodal region.
On this page
CMS RVU26D · Effective 2026-10-01
38564 Node dissection Medicare reimbursement rates in Kentucky
Reports a limited open removal of retroperitoneal lymph nodes for staging or treatment when the operative field and extent support this service. Compare 38564 office and facility rates across CMS payment localities in Kentucky.
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 38564 in Kentucky?
Kentucky 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
$632.12
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Surgical oncology
About 38564: Limited open retroperitoneal lymphadenectomy
Reports a limited open removal of retroperitoneal lymph nodes for staging or treatment when the operative field and extent support this service.
This service involves open surgical removal of a limited amount of lymph-node tissue from the retroperitoneum. It is typically performed by a surgeon during an abdominal operation for cancer staging or treatment; retroperitoneal nodal surgery may be part of care for testicular or other abdominal and pelvic malignancies. The operative report should establish the open approach, the retroperitoneal location, and the limited extent of the dissection.
Select this code for the documented procedure rather than a superficial-node biopsy, laparoscopic sampling, or a more extensive dissection. Medicare 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 are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 38564
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU11.10 · 56%
- Practice expense (office) RVU6.26 · 32%
- Malpractice RVU2.47 · 12%
341
Medicare services in 2024 · #3880 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.
38564 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
Code 38570 describes laparoscopic retroperitoneal node sampling. Use 38564 for a limited open dissection, not laparoscopic sampling.
No office rate
Code 38571 describes laparoscopic bilateral total pelvic lymphadenectomy. It differs from this code in both approach and nodal field.
No office rate
Code 38572 represents laparoscopic pelvic lymphadenectomy with para-aortic nodal work. Code 38564 is for a limited open retroperitoneal dissection.
Compare 38564 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$632.12
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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 38564 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
4,752
- Code
- 38564
- Physician work
- 11.10
- Practice expense
- 6.26
- Malpractice
- 2.47
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.10 | × 1.000 | 11.1000 |
| Practice expense | 6.26 | × 0.889 | 5.5651 |
| Malpractice | 2.47 | × 0.915 | 2.2601 |
| Total RVUs | 18.9252 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$632.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.1 | 1 |
| Practice expense | 6.26 | 0.889 |
| Malpractice | 2.47 | 0.915 |
(11.1 × 1 + 6.26 × 0.889 + 2.47 × 0.915) × $33.4009 = $632.12
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.
38564 billing questions
How does this differ from code 38562?
Code 38564 is for limited open retroperitoneal node removal. Code 38562 describes limited pelvic lymphadenectomy, so the documented nodal field distinguishes them.
When would a laparoscopic code be more appropriate?
Use the applicable laparoscopic code when the nodal procedure is performed laparoscopically. Code 38564 represents an open retroperitoneal dissection.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What documentation supports reporting 38564?
The operative report should identify the open approach, retroperitoneal nodal location, and limited extent of removal, along with the clinical indication.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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.
4,74938550,,Removal neck/armpit lesion,A,,6.93,6.72,NA,6.72,,1.85,15.50,15.50,0,090,0.11,0.73,0.16,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,75038555,,Removal neck/armpit lesion,A,,15.20,10.18,NA,10.18,,4.06,29.44,29.44,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,75138562,,Removal pelvic lymph nodes,A,,10.78,7.02,NA,7.02,,2.25,20.05,20.05,0,090,0.11,0.73,0.16,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,75238564,,Removal abdomen lymph nodes,A,,11.10,6.26,NA,6.26,,2.47,19.83,19.83,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,75338570,,Laparoscopy lymph node biop,A,,8.28,4.38,NA,4.38,,1.73,14.39,14.39,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
4,75438571,,Laparoscopy lymphadenectomy,A,,11.70,4.49,NA,4.49,,1.67,17.86,17.86,0,010,0.10,0.80,0.10,3,2,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
4,75538572,,Laparoscopy lymphadenectomy,A,,15.21,6.59,NA,6.59,,2.92,24.72,24.72,0,010,0.10,0.80,0.10,3,2,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631