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CMS RVU26D · Effective 2026-10-01

38542 Node exploration Medicare reimbursement rates in Oklahoma

Reports operative exploration of deep cervical lymph nodes when a surgeon evaluates the deep neck node basin, rather than performing a needle sample or defined node excision. Compare 38542 office and facility rates across CMS payment localities in Oklahoma.

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 38542 in Oklahoma?

Oklahoma 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

$441.91

1 of 1 localities have a supported rate.

Payment area: Oklahoma

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 38542 in your payment locality →

Lymph node surgery

About 38542: Deep cervical lymph node exploration

Reports operative exploration of deep cervical lymph nodes when a surgeon evaluates the deep neck node basin, rather than performing a needle sample or defined node excision.

A surgeon explores deep cervical lymph nodes in the neck, commonly during an operative evaluation of suspicious cervical adenopathy. The work involves accessing and examining the deep node basin; an otolaryngologist, head and neck surgeon, or another surgeon may perform it in a hospital operating room. This is distinct from a needle sample and from a procedure whose documented service is biopsy or excision of a node.

Report the code when the operative note supports exploration of deep cervical nodes, including the approach, anatomic site, findings, and whether tissue was sampled or removed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. 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. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

CMS billing rules for 38542

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 procedure with modifier 50 is paid at 150%.
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 RVU7.75 · 55%
  • Practice expense (office) RVU4.98 · 35%
  • Malpractice RVU1.33 · 9%

528

Medicare services in 2024 · #3507 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.

38542 compared with similar codes

Office rates for Oklahoma, from the same CMS release.

38510

Lymph node biopsy

Open, deep cervical

$510.71

Choose 38510 when the documented service is open biopsy or excision of deep cervical node(s). Choose 38542 for exploration of the deep cervical node basin.

38520

Lymph node biopsy

Deep cervical with scalene fat pad

No office rate

This code includes deep cervical node biopsy or excision with scalene fat pad excision. Exploration without that documented work is distinct.

38724

Neck dissection

Modified radical

No office rate

Code 38724 represents cervical lymphadenectomy, a more extensive dissection. Exploration of deep cervical nodes alone is not a substitute for a documented lymphadenectomy.

Compare 38542 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 38542 in Oklahoma.

PPRRVU2026_Oct_nonQPP.csv

4,748

Code
38542
Physician work
7.75
Practice expense
4.98
Malpractice
1.33

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Facility calculation for 38542 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work7.75× 1.0007.7500
Practice expense4.98× 0.8934.4471
Malpractice1.33× 0.7771.0334
Total RVUs13.2306
Conversion factor× 33.4009

Facility rate, Oklahoma$441.91

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.751
Practice expense4.980.893
Malpractice1.330.777

(7.75 × 1 + 4.98 × 0.893 + 1.33 × 0.777) × $33.4009 = $441.91

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.

38542 billing questions

How is this different from 38510?

This code describes exploration of deep cervical nodes. Code 38510 describes open biopsy or excision of deep cervical node(s); report the service documented in the operative note.

When would 38520 be more appropriate?

Code 38520 describes open biopsy or excision of deep cervical node(s) with scalene fat pad excision. Use it when that additional work is documented, rather than for exploration alone.

Can this be reported with a neck dissection?

A comprehensive cervical lymphadenectomy, such as 38724, represents a different and more extensive service. Do not separately report exploration when it is part of the documented dissection.

How is bilateral exploration reported?

For a bilateral procedure reported with modifier 50, CMS pays 150%. The operative documentation should support exploration on both sides.

What documentation supports this code?

Document the deep cervical node basin explored, the operative approach, the findings, and any sampling or removal performed. The note should distinguish exploration from a needle procedure or open biopsy/excision.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The code also has a 90-day global period.

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 38542PPRRVU2026_Oct_nonQPP.csv, line 4,748 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet