Billing code 38724: Neck dissectionMedicare rate & RVUs in Washington
Reports a modified radical cervical lymphadenectomy for removing cervical lymph nodes, typically for metastatic head and neck cancer, while preserving selected nonlymphatic structures.
CMS doesn’t publish an office rate for 38724 in Washington.
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 38724 covers
A modified radical neck dissection removes cervical lymph-node tissue while preserving one or more nonlymphatic structures that would be sacrificed in a more extensive operation, such as the spinal accessory nerve, internal jugular vein, or sternocleidomastoid muscle. Head and neck surgeons commonly perform it in a hospital operating room for cervical nodal metastases from cancers such as oral cavity, oropharyngeal, laryngeal, or thyroid malignancies. The operative report should establish the dissection performed and identify preserved structures when relevant.
Select this code from the actual operative extent and technique, not simply the cancer diagnosis or the number of positive nodes. Report the neck dissection separately from other procedures only when supported as a distinct service. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 38724 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,262.28 |
| Seattle (King Cnty) | Unavailable | $1,360.58 |
How the 38724 rate is calculated
Each of 38724’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 · 38724
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 23.35Practice expense 10.76Malpractice 3.69
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 38724
38724 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 38724
Neck dissection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.73/0.16 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 38724
Neck dissection
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
38724 without 50 · national facility
$1,262.55
Neck dissection
38724-50 · Bilateral: 150%
$1,893.83
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).
38724 compared with similar codes
Compare codes
38724 vs 38720 vs 38700 vs 38792: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 38720Neck node removal
- 38724 describes a modified radical dissection that preserves selected nonlymphatic structures. Use 38720 when the documented cervical lymphadenectomy has a different, more extensive operative plan.
- 38700Neck lymphadenectomy
- 38700 is for suprahyoid lymphadenectomy, a more limited neck-node procedure. It is not the code for a modified radical cervical dissection.
- 38792Sentinel node injection
- 38792 reports injection of tracer to help identify a sentinel node. It does not report removal of cervical lymph-node tissue by modified radical dissection.
38724 billing questions
How does 38724 differ from 38720?
Use 38724 for a modified radical neck dissection that preserves one or more nonlymphatic structures. Choose 38720 when the operative approach is a complete cervical lymphadenectomy of a different extent.
Does 38724 include the primary tumor resection?
The code describes the cervical lymphadenectomy, not the primary tumor operation. Report another procedure only when the operative documentation supports it as a distinct service.
How is bilateral neck dissection reported?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%. The operative record should document dissection on both sides.
What documentation supports 38724?
Document the cervical nodal dissection performed, its extent, and the nonlymphatic structures preserved. The operative details should support a modified radical dissection rather than a more limited or different neck procedure.
How does the multiple-procedure reduction affect 38724?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%. The neck dissection's rank depends on the values of the procedures reported for that session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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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