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CMS RVU26D · Effective 2026-10-01

38505 Lymph node biopsy Medicare reimbursement rates in Massachusetts

Percutaneous needle sampling of a superficial lymph node for tissue diagnosis, commonly used to evaluate palpable or imaging-detected cervical, axillary, or inguinal adenopathy. Compare 38505 office and facility rates across CMS payment localities in Massachusetts.

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 38505 in Massachusetts?

Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$176.00–$193.74

2 of 2 localities have a supported rate.

Lowest: Rest Of Massachusetts

Highest: Metropolitan Boston

A spread of $17.74 per service.

Facility setting

$75.41–$79.69

2 of 2 localities have a supported rate.

Lowest: Rest Of Massachusetts

Highest: Metropolitan Boston

A spread of $4.28 per service.

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.

Find 38505 in your payment locality →

Surgical procedures

About 38505: Superficial lymph node needle biopsy

Percutaneous needle sampling of a superficial lymph node for tissue diagnosis, commonly used to evaluate palpable or imaging-detected cervical, axillary, or inguinal adenopathy.

Code 38505 describes needle sampling of a superficial lymph node to obtain tissue for diagnostic evaluation. It is commonly performed for enlarged or suspicious cervical, axillary, or inguinal nodes, including nodes identified on examination or imaging. Radiologists, surgeons, and other qualified physicians may perform the procedure in an office, imaging department, or facility setting. The needle technique distinguishes this service from open removal or biopsy of a node.

Report the code when the documented procedure involves needle biopsy of a superficial node; record the sampled site and the technique used. Same-day preoperative and postoperative care is included in its 0-day global period. 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. For bilateral service, modifier 50 results in payment at 150%. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

CMS billing rules for 38505

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.55 · 30%
  • Practice expense (office) RVU3.38 · 66%
  • Malpractice RVU0.17 · 3%

36.6K

Medicare services in 2024 · #902 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.

38505 compared with similar codes

Office rates for Massachusetts, from the same CMS release.

38500

Lymph node biopsy

Open, superficial node

$376.72–$413.03

Choose 38505 for needle sampling of a superficial node; choose 38500 when the node is biopsied or removed through an open approach.

38510

Lymph node biopsy

Open, deep cervical

$561.35–$611.56

38510 describes an open procedure on a deep cervical node. 38505 describes needle sampling of a superficial node.

10005

Ultrasound-guided FNA

First lesion

$136.07–$148.94

10005 is for fine needle aspiration with imaging guidance. 38505 is for needle biopsy of a superficial lymph node, rather than an aspiration service.

Compare 38505 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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38505 billing questions

When should 38505 be used instead of 38500?

Use 38505 for needle sampling of a superficial lymph node. Code 38500 describes an open biopsy or removal of a superficial node.

How does 38505 differ from fine needle aspiration?

38505 represents needle biopsy of a superficial node, commonly performed to obtain tissue. Fine needle aspiration codes apply when the service is aspiration sampling, with code selection depending on whether imaging guidance is used.

Can modifier 50 be reported for bilateral node biopsies?

Yes. CMS identifies 38505 as bilateral, and modifier 50 results in payment at 150% when the procedure is performed bilaterally.

Does the code include same-day postoperative care?

Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be paid for 38505?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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.

RVUs for 38505PPRRVU2026_Oct_nonQPP.csv, line 4,742 (RVU26D)