38765

Remove groin lymph nodes

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary38765Remove groin lymph nodes
1
$1,225.48
$1,225.48
Add-on38900Io map of sent lymph node
0
$144.96/ unit
$122.92/ unit
Whole procedure · 21.36 wRVU credited
$1,225.48
$1,225.48

RVU Breakdown

Component
Office
Facility
Work
21.36
21.36
Practice expense
10.50
10.50
Malpractice
4.83
4.83
Total RVU
36.69
36.69

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $1,838.22 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.