Billing code 38500: Lymph node biopsyMedicare rate & RVUs in Oregon
Open biopsy or excision of a superficial lymph node is reported when tissue sampling or removal requires direct surgical exposure.
Medicare pays $359.62–$387.65 for 38500 in the office in Oregon, from Rest Of Oregon to Portland. 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 38500 covers
Code 38500 describes open sampling or removal of one or more superficial lymph nodes through a surgical incision. The surgeon exposes the node directly and removes all or part of it for pathologic evaluation. It is used when an accessible superficial node needs tissue diagnosis or excision, rather than needle sampling or removal from a deep nodal basin. Surgeons commonly perform this service in hospital outpatient departments and ambulatory surgery settings; office performance is also represented in Medicare claims.
Select the code based on the open approach and superficial location, not solely on the diagnosis or pathology result. The operative report should identify the site, approach, and whether the node was sampled or removed, and the record should support the clinical reason for obtaining tissue. Related postoperative visits during the 10-day global period are included. 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 reporting with modifier 50, CMS payment is 150%. Assistant-at-surgery payment is restricted; 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.
Where 38500 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $387.65 | $249.97 |
| Rest Of Oregon | $359.62 | $236.20 |
How the 38500 rate is calculated
Each of 38500’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 · 38500
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.70Practice expense 6.46Malpractice 0.90
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 38500
38500 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 38500
Lymph node biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 38500
Lymph node biopsy
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
38500 without 50 · national office
$369.41
Lymph node biopsy
38500-50 · Bilateral: 150%
$554.12
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).
38500 compared with similar codes
Compare codes
38500 vs 38505 vs 38510 vs 38525 vs 38531: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 38505Lymph node biopsy
- 38505 describes needle biopsy of a lymph node. Use 38500 when the surgeon uses an open incision to reach a superficial node.
- 38510Lymph node biopsy
- 38510 is for open biopsy or excision of deep cervical nodes. Code 38500 is for superficial nodes.
- 38525Axillary node biopsy
- 38525 is for open biopsy or excision of deep axillary nodes; 38500 is selected for superficial nodes.
- 38531Groin node surgery
- 38531 identifies open biopsy or excision of inguinofemoral nodes. Use 38500 for superficial nodes at other sites when its description fits.
38500 billing questions
When should 38500 be used instead of 38505?
Use 38500 when the surgeon obtains the superficial node through an open incision. Code 38505 is for needle biopsy of a lymph node.
How does the location affect code selection?
Code 38500 is for superficial nodes. Deep cervical, deep axillary, internal mammary, and inguinofemoral node procedures have distinct codes, including 38510, 38525, 38530, and 38531.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure.
How is bilateral 38500 paid?
When reported bilaterally with modifier 50, CMS pays 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is restricted 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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