Billing code 39200: Mediastinal cystMedicare rate & RVUs in Maine
Surgical removal of a cyst in the mediastinum, reported when the operative service is definitive excision rather than tumor resection or diagnostic sampling.
CMS doesn’t publish an office rate for 39200 in Maine.
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 39200 covers
Code 39200 describes open surgical removal of a cyst located in the mediastinum, the central compartment of the chest between the lungs. A thoracic or cardiothoracic surgeon typically performs the operation in a hospital operating room. A bronchogenic cyst is one example; the operative record should establish that the lesion is cystic and mediastinal, rather than a solid tumor or a lesion in another chest compartment.
Report the code when the surgeon resects the cyst, not when the service is limited to diagnostic sampling. The operative report should document the lesion’s location, cystic nature, and the procedure performed. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require 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 39200 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | Unavailable | $767.63 |
| Southern Maine | Unavailable | $784.13 |
How the 39200 rate is calculated
Each of 39200’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 · 39200
RVUs × geographic indexes × conversion factor
Work14.71
14.71 RVUs× 1.000 GPCI
Practice expense6.49
6.49 RVUs× 1.000 GPCI
Malpractice3.70
3.70 RVUs× 1.000 GPCI
Adjusted RVUs
24.9000
Conversion factor
$33.4009
Medicare rate
$831.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 39200
39200 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 39200
Mediastinal cyst
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 39200
Mediastinal cyst
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 51 · payment effect
With and without the modifier
39200 without 51 · national facility
$831.68
Mediastinal cyst
39200-51 · Second procedure: 50%
$415.84
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%).
39200 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 39220Mediastinal resection
- Choose 39200 for resection of a mediastinal cyst and 39220 for resection of a mediastinal tumor.
- 32662Mediastinal excision
- 32662 describes thoracoscopic excision of a mediastinal cyst, tumor, or mass; 39200 is the open resection code.
- 39401Mediastinoscopy
- 39401 is mediastinoscopy with lymph-node biopsy for diagnostic sampling. It does not represent surgical removal of a mediastinal cyst.
39200 billing questions
How is this code distinguished from mediastinal tumor resection?
Use 39200 for resection of a mediastinal cyst. Code 39220 describes resection of a mediastinal tumor.
Can this code be used for a diagnostic biopsy?
No. This code represents surgical removal of the cyst; a service limited to diagnostic sampling is not cyst resection.
Should modifier 50 be appended for bilateral treatment?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
How does the multiple-procedure reduction affect payment?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
What surgical-assistance billing rules apply?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and 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 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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