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CMS RVU26D · Effective 2026-10-01

39010 Mediastinotomy Medicare reimbursement rates in North Dakota

Report transthoracic mediastinotomy when a surgeon enters the mediastinum through the chest to explore, drain, remove a foreign body, or obtain a biopsy. Compare 39010 office and facility rates across CMS payment localities in North Dakota.

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 39010 in North Dakota?

North Dakota 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

$699.91

1 of 1 localities have a supported rate.

Payment area: North Dakota**

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.

Find 39010 in your payment locality →

Thoracic surgery

About 39010: Transthoracic mediastinal exploration

Report transthoracic mediastinotomy when a surgeon enters the mediastinum through the chest to explore, drain, remove a foreign body, or obtain a biopsy.

This open approach gives the surgeon access to the mediastinum through the chest wall. A thoracic surgeon may use it to investigate a mediastinal abnormality, obtain tissue, drain a collection, or remove a foreign body. The code encompasses the exploration and the listed work performed through that approach; it is distinct from access through the neck. These procedures are generally performed in an operating room with the patient under anesthesia.

Select the code based on the transthoracic route and document the indication, operative approach, mediastinal findings, and work performed. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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. CMS may pay for an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 39010

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 RVU12.86 · 56%
  • Practice expense (office) RVU6.82 · 30%
  • Malpractice RVU3.14 · 14%

517

Medicare services in 2024 · #3536 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.

39010 compared with similar codes

Office rates for North Dakota, from the same CMS release.

39000

Mediastinal exploration

Cervical approach

No office rate

Choose 39000 for a cervical mediastinotomy; choose 39010 when the surgeon reaches the mediastinum through the chest.

32100

Chest exploration

Open thoracic exploration

No office rate

32100 describes thoracotomy exploration. Use 39010 when the operative work is specifically mediastinal exploration through a transthoracic mediastinotomy.

Compare 39010 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

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

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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 39010 in North Dakota**.

PPRRVU2026_Oct_nonQPP.csv

4,775

Code
39010
Physician work
12.86
Practice expense
6.82
Malpractice
3.14

GPCI2026.csv

84

Locality
North Dakota**
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Facility calculation for 39010 in North Dakota**
ComponentRVULocality factorAdjusted
Physician work12.86× 1.00012.8600
Practice expense6.82× 1.0006.8200
Malpractice3.14× 0.4061.2748
Total RVUs20.9548
Conversion factor× 33.4009

Facility rate, North Dakota**$699.91

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work12.861
Practice expense6.821
Malpractice3.140.406

(12.86 × 1 + 6.82 × 1 + 3.14 × 0.406) × $33.4009 = $699.91

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.

39010 billing questions

How does this differ from 39000?

39010 is for transthoracic access to the mediastinum. Use 39000 when the mediastinotomy is performed through a cervical approach.

Is exploration separately reported from biopsy or drainage?

The code includes exploration and may encompass drainage, foreign-body removal, or biopsy performed through the transthoracic approach. Do not treat those listed components as separate procedures solely because they are also performed.

Should modifier 50 be appended for bilateral work?

No. CMS identifies modifier 50 as inappropriate for this code.

Can an assistant or co-surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What documentation supports 39010?

Document why mediastinal access was needed, that the approach was transthoracic, the operative findings, and whether exploration, drainage, foreign-body removal, or biopsy was performed.

How does the 90-day global period affect postoperative billing?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. The record should support whether subsequent care is related to the operation.

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 39010PPRRVU2026_Oct_nonQPP.csv, line 4,775 (RVU26D)
Geographic factors for North Dakota**GPCI2026.csv, line 84 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet