38530

Biopsy/removal lymph nodes

Add to my model
Code typePrimary
Payment statusActive (A)
Global period90-day

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary38530Biopsy/removal lymph nodes
1
$530.74
$530.74
Add-on38900Io map of sent lymph node
0
$144.96/ unit
$122.92/ unit
Whole procedure · 8.13 wRVU credited
$530.74
$530.74

RVU Breakdown

Component
Office
Facility
Work
8.13
8.13
Practice expense
6.04
6.04
Malpractice
1.72
1.72
Total RVU
15.89
15.89

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $796.11 office.
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%. Add-on codes are exempt.
Assistant surgeon -80/81/8216%
Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.
Co-surgeons -6262.5% each
Co-surgeons paid (62.5% each) if medical necessity is documented.
Not applicable to this code
Team surgeon -66Prof / tech split

Global surgery package

Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 11% is attributed to pre-operative care, 73% to the procedure itself, and 16% to post-operative visits.