Billing code 38790: Lymphangiography injectionMedicare rate & RVUs in Texas
Reports contrast injection into lymphatic channels to prepare for lymphangiography, commonly through peripheral lymphatic access for evaluation of abnormal lymphatic drainage.
CMS doesn’t publish an office rate for 38790 in Texas.
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 38790 covers
This service covers placing contrast into the lymphatic system so the channels can be visualized during lymphangiography. A common approach is access to lymphatic vessels in the foot; an interventional radiologist or surgeon may perform the injection as part of imaging for suspected lymphatic obstruction or abnormal drainage. The injection procedure is distinct from the radiologic imaging and interpretation service.
Report the procedure when the clinician documents lymphatic access and contrast injection, including the access site and laterality. Pair it with the appropriate lymphangiography imaging code when that imaging service is performed and reported. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 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 38790 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $76.71 |
| Beaumont | Unavailable | $72.91 |
| Brazoria | Unavailable | $74.44 |
| Dallas | Unavailable | $75.14 |
| Fort Worth | Unavailable | $74.96 |
| Galveston | Unavailable | $74.82 |
| Houston | Unavailable | $78.48 |
| Rest Of Texas | Unavailable | $73.79 |
How the 38790 rate is calculated
Each of 38790’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 · 38790
RVUs × geographic indexes × conversion factor
Work1.26
1.26 RVUs× 1.000 GPCI
Practice expense0.81
0.81 RVUs× 1.000 GPCI
Malpractice0.20
0.20 RVUs× 1.000 GPCI
Adjusted RVUs
2.2700
Conversion factor
$33.4009
Medicare rate
$75.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38790
The CMS indicators that decide how 38790 is paid alongside other services.
CMS payment indicators · 38790
Lymphangiography injection
| 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
38790 without 50 · national facility
$75.82
Lymphangiography injection
38790-50 · Bilateral: 150%
$113.73
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).
38790 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 38792Sentinel node injection
- Use 38790 for contrast injection to visualize lymphatic channels. Use 38792 for injection used to identify a sentinel lymph node.
- 38794Thoracic duct access
- This code describes lymphangiography injection through lymphatic access; 38794 concerns access to the thoracic duct for lymphangiography.
- 75801Lymph vessel x-ray arm/leg
- This code represents the injection procedure. Code 75801 represents radiologic supervision and interpretation for extremity lymphangiography.
38790 billing questions
How is this different from 38792?
This code represents contrast injection for lymphangiography. Code 38792 concerns injection for sentinel node identification, such as mapping a node for a biopsy or cancer operation.
Can lymphangiography imaging be reported separately?
The injection and the radiologic imaging service are distinct. When imaging is performed and reported, use the appropriate lymphangiography imaging code for the region examined.
When is modifier 50 appropriate?
CMS identifies this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%. Documentation should support injection on both sides.
What documentation supports the injection?
Record the clinical purpose, lymphatic access site and side, contrast injection, and the imaging performed. The documentation should distinguish lymphatic contrast injection from sentinel-node tracer or dye injection.
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%. Same-day preoperative and postoperative care is included in this code's 0-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 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
Fee sheets
Put 38790 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →