$159.78–$176.35
38505 describes needle biopsy of a lymph node. Use 38500 when the surgeon uses an open incision to reach a superficial node.
On this page
CMS RVU26D · Effective 2026-10-01
38500 Lymph node biopsy Medicare reimbursement rates in Texas
Open biopsy or excision of a superficial lymph node is reported when tissue sampling or removal requires direct surgical exposure. Compare 38500 office and facility rates across CMS payment localities in Texas.
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 38500 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$347.86–$380.20
8 of 8 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.
Where 38500 pays more and less in Texas
8 payment localities
$347.86 to $380.20
Lymph node surgery
About 38500: Open superficial lymph node biopsy or excision
Open biopsy or excision of a superficial lymph node is reported when tissue sampling or removal requires direct surgical exposure.
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.
CMS billing rules for 38500
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.70 · 33%
- Practice expense (office) RVU6.46 · 58%
- Malpractice RVU0.90 · 8%
5K
Medicare services in 2024 · #1867 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.
38500 compared with similar codes
Office rates for Texas, from the same CMS release.
$522.07–$566.80
38510 is for open biopsy or excision of deep cervical nodes. Code 38500 is for superficial nodes.
No office rate
38525 is for open biopsy or excision of deep axillary nodes; 38500 is selected for superficial nodes.
No office rate
38531 identifies open biopsy or excision of inguinofemoral nodes. Use 38500 for superficial nodes at other sites when its description fits.
Compare 38500 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $378.75 | Facility $247.64 |
| Beaumont | Office $347.86 | Facility $235.10 |
| Brazoria | Office $361.85 | Facility $239.05 |
| Dallas | Office $365.39 | Facility $241.97 |
| Fort Worth | Office $363.63 | Facility $241.45 |
| Galveston | Office $363.72 | Facility $240.67 |
| Houston | Office $380.20 | Facility $257.15 |
| Rest Of Texas | Office $355.49 | Facility $237.90 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
4,73838380,,Thoracic duct procedure,A,,8.25,5.94,NA,5.94,,1.33,15.52,15.52,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73938381,,Thoracic duct procedure,A,,13.05,6.84,NA,6.84,,3.21,23.10,23.10,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74038382,,Thoracic duct procedure,A,,10.38,7.16,NA,7.16,,2.61,20.15,20.15,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74138500,,Biopsy/removal lymph nodes,A,,3.70,6.46,,2.75,,0.90,11.06,7.35,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74238505,,Needle biopsy lymph nodes,A,,1.55,3.38,,0.52,,0.17,5.10,2.24,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74338510,,Biopsy/removal lymph nodes,A,,6.57,8.66,,3.48,,1.27,16.50,11.32,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,74438520,,Biopsy/removal lymph nodes,A,,6.85,4.86,NA,4.86,,1.49,13.20,13.20,0,090,0.11,0.73,0.16,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00