$353.40
Choose 38510 for open sampling or removal of deep cervical nodes; 38500 is for superficial lymph nodes.
On this page
CMS RVU26D · Effective 2026-10-01
38510 Lymph node biopsy Medicare reimbursement rates in Utah
Reports open biopsy or excision of deep cervical lymph nodes when a surgeon obtains nodal tissue for diagnosis, such as evaluating suspected lymphoma or metastatic disease. Compare 38510 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 38510 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
$529.43
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$366.80
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 procedure
About 38510: Open deep cervical lymph node biopsy
Reports open biopsy or excision of deep cervical lymph nodes when a surgeon obtains nodal tissue for diagnosis, such as evaluating suspected lymphoma or metastatic disease.
This code covers an open surgical biopsy or removal of one or more deep cervical lymph nodes, commonly from the deep neck chain. An otolaryngologist, head and neck surgeon, or general surgeon may perform it when imaging or examination identifies a node requiring tissue diagnosis, including workup for suspected lymphoma or metastatic cancer. The node is submitted for pathologic examination; this is different from sampling a superficial neck node or using a needle approach.
Report the code for the open deep cervical procedure, documenting the node’s location, the operative approach, and whether biopsy or excision was performed. The 10-day global period includes related postoperative visits during that period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. For bilateral work, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 38510
- 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 RVU6.57 · 40%
- Practice expense (office) RVU8.66 · 52%
- Malpractice RVU1.27 · 8%
6.7K
Medicare services in 2024 · #1688 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.
38510 compared with similar codes
Office rates for Utah, from the same CMS release.
$162.99
Choose 38505 for percutaneous needle sampling. The open surgical approach to a deep cervical node is reported with 38510.
No office rate
38520 includes the scalene fat pad with open deep cervical node work. Use 38510 when that tissue is not included.
No office rate
Both describe open nodal procedures, but 38525 is for deep axillary nodes; 38510 is for deep cervical nodes.
Compare 38510 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
$529.43
Facility
$366.80
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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 38510 in Utah.
PPRRVU2026_Oct_nonQPP.csv
4,743
- Code
- 38510
- Physician work
- 6.57
- Practice expense
- 8.66
- Malpractice
- 1.27
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.57 | × 1.000 | 6.5700 |
| Practice expense | 8.66 | × 0.940 | 8.1404 |
| Malpractice | 1.27 | × 0.898 | 1.1405 |
| Total RVUs | 15.8509 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$529.43
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.57 | 1 |
| Practice expense | 8.66 | 0.94 |
| Malpractice | 1.27 | 0.898 |
(6.57 × 1 + 8.66 × 0.94 + 1.27 × 0.898) × $33.4009 = $529.43
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.57 | 1 |
| Practice expense | 3.48 | 0.94 |
| Malpractice | 1.27 | 0.898 |
(6.57 × 1 + 3.48 × 0.94 + 1.27 × 0.898) × $33.4009 = $366.80
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.
38510 billing questions
How does this differ from 38500?
38510 is for open work on deep cervical nodes. Code 38500 applies to open biopsy or excision of superficial lymph nodes.
Can 38510 be used for a needle biopsy?
No. For percutaneous needle sampling of a lymph node, consider 38505; 38510 describes an open surgical approach to deep cervical nodes.
When is 38520 more appropriate?
38520 describes open deep cervical node work that includes the scalene fat pad. Use 38510 when that additional tissue is not part of the procedure.
How is bilateral deep cervical work reported?
The CMS payment rule identifies modifier 50 for bilateral procedures and pays the procedure at 150%. Document the work on both sides.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure’s payment.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 38510. Co-surgeons and team surgery are not permitted under the listed CMS rules.
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.
4,74038382,,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
4,74638530,,Biopsy/removal lymph nodes,A,,8.13,6.04,NA,6.04,,1.72,15.89,15.89,0,090,0.11,0.73,0.16,2,1,2,1,0,9,,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