$353.40
Choose 38505 for needle sampling of a superficial node; choose 38500 when the node is biopsied or removed through an open approach.
On this page
CMS RVU26D · Effective 2026-10-01
38505 Lymph node biopsy Medicare reimbursement rates in Utah
Percutaneous needle sampling of a superficial lymph node for tissue diagnosis, commonly used to evaluate palpable or imaging-detected cervical, axillary, or inguinal adenopathy. Compare 38505 office and facility rates across CMS payment localities in Utah.
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 38505 in Utah?
Utah 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
$162.99
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$73.20
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Surgical procedures
About 38505: Superficial lymph node needle biopsy
Percutaneous needle sampling of a superficial lymph node for tissue diagnosis, commonly used to evaluate palpable or imaging-detected cervical, axillary, or inguinal adenopathy.
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.
CMS billing rules for 38505
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.55 · 30%
- Practice expense (office) RVU3.38 · 66%
- Malpractice RVU0.17 · 3%
36.6K
Medicare services in 2024 · #902 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.
38505 compared with similar codes
Office rates for Utah, from the same CMS release.
$529.43
38510 describes an open procedure on a deep cervical node. 38505 describes needle sampling of a superficial node.
$126.94
10005 is for fine needle aspiration with imaging guidance. 38505 is for needle biopsy of a superficial lymph node, rather than an aspiration service.
Compare 38505 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
Utah →
Office / nonfacility
$162.99
Facility
$73.20
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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 38505 in Utah.
PPRRVU2026_Oct_nonQPP.csv
4,742
- Code
- 38505
- Physician work
- 1.55
- Practice expense
- 3.38
- Malpractice
- 0.17
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.55 | × 1.000 | 1.5500 |
| Practice expense | 3.38 | × 0.940 | 3.1772 |
| Malpractice | 0.17 | × 0.898 | 0.1527 |
| Total RVUs | 4.8799 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$162.99
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.55 | 1 |
| Practice expense | 3.38 | 0.94 |
| Malpractice | 0.17 | 0.898 |
(1.55 × 1 + 3.38 × 0.94 + 0.17 × 0.898) × $33.4009 = $162.99
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.55 | 1 |
| Practice expense | 0.52 | 0.94 |
| Malpractice | 0.17 | 0.898 |
(1.55 × 1 + 0.52 × 0.94 + 0.17 × 0.898) × $33.4009 = $73.20
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.
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 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.
4,73938381,,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
4,74538525,,Biopsy/removal lymph nodes,A,,6.27,5.01,NA,5.01,,1.61,12.89,12.89,0,090,0.11,0.73,0.16,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985