No office rate
Use 38746 for regional thoracic nodes, such as mediastinal and peritracheal nodes; 38747 is for regional abdominal lymphadenectomy.
On this page
CMS RVU26D · Effective 2026-10-01
38746 Lymph node dissection Medicare reimbursement rates in Michigan
Report this add-on for regional thoracic lymph node dissection, such as mediastinal and peritracheal node removal performed with a primary thoracic operation. Compare 38746 office and facility rates across CMS payment localities in Michigan.
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 38746 in Michigan?
Michigan 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
No supported rate
Facility setting
$197.44–$217.82
2 of 2 localities have a supported rate.
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.
Thoracic surgery
About 38746: Thoracic regional lymph node dissection
Report this add-on for regional thoracic lymph node dissection, such as mediastinal and peritracheal node removal performed with a primary thoracic operation.
This service captures regional removal of thoracic lymph nodes, including mediastinal and peritracheal nodes, during a thoracic operation. A thoracic surgeon commonly performs it as part of lung cancer surgery, such as a lobectomy, in a hospital operating room. The lymph node dissection is distinct from the operation that provides access to or removes lung tissue.
Report 38746 only with a qualifying primary procedure; it is not a stand-alone service. The operative report should support that a regional thoracic lymphadenectomy was performed and identify the nodal area or stations addressed. The CMS add-on rule places payment for this service within the primary procedure’s global period. Examples of primary procedures with which it may be reported include open or thoracoscopic lung resection, when the documented work supports the separate add-on.
CMS billing rules for 38746
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.02 · 69%
- Practice expense (office) RVU0.81 · 14%
- Malpractice RVU1.02 · 17%
2.9K
Medicare services in 2024 · #2193 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.
38746 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
Use 38746 for thoracic nodal dissection. Code 38745 describes complete axillary lymphadenectomy, not removal of thoracic nodes.
$77.35–$81.71
Code 38792 reports radiotracer identification of a sentinel node. It does not represent regional thoracic lymph node dissection.
Compare 38746 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
Detroit →
Office / nonfacility
Unavailable
Facility
$217.82
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$197.44
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38746 billing questions
Can 38746 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure.
What documentation supports reporting 38746?
The operative report should describe the regional thoracic lymph node dissection and identify the nodal area or stations addressed.
Is 38746 included in the lung resection code?
It represents the additional regional lymphadenectomy work and is reported with the primary thoracic procedure when that work was performed and documented.
How does CMS handle the global period?
CMS treats 38746 as an add-on paid within the global period of its primary procedure.
Is 38746 used for abdominal node removal?
No. It is for thoracic regional nodes; 38747 is the related add-on for regional abdominal lymphadenectomy.
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.
4,76038724,,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
4,76638765,,Remove groin lymph nodes,A,,21.36,10.50,NA,10.50,,4.83,36.69,36.69,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00