Billing code 38505: Lymph node biopsyMedicare rate & RVUs in Ohio
Percutaneous needle sampling of a superficial lymph node for tissue diagnosis, commonly used to evaluate palpable or imaging-detected cervical, axillary, or inguinal adenopathy.
Medicare pays $160.57 for 38505 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 38505 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $160.57 | $73.35 |
How the 38505 rate is calculated
Each of 38505’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 · 38505
RVUs × geographic indexes × conversion factor
Work1.55
1.55 RVUs× 1.000 GPCI
Practice expense3.38
3.38 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
5.1000
Conversion factor
$33.4009
Medicare rate
$170.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38505
The CMS indicators that decide how 38505 is paid alongside other services.
CMS payment indicators · 38505
Lymph node biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
38505 without 50 · national office
$170.34
Lymph node biopsy
38505-50 · Bilateral: 150%
$255.51
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
38505 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 38500Lymph node biopsy
- Choose 38505 for needle sampling of a superficial node; choose 38500 when the node is biopsied or removed through an open approach.
- 38510Lymph node biopsy
- 38510 describes an open procedure on a deep cervical node. 38505 describes needle sampling of a superficial node.
- 10005Ultrasound-guided FNA
- 10005 is for fine needle aspiration with imaging guidance. 38505 is for needle biopsy of a superficial lymph node, rather than an aspiration service.
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 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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