CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 38520 RVU and Medicare Payment (2026)
Biopsy/removal lymph nodes — 6.85 work RVU, about $440.89 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 6.85
- PE RVU (non-facility)
- 4.86
- PE RVU (facility)
- 4.86
- MP RVU
- 1.49
- Office payment
- $440.89
- Facility payment
- $440.89
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 38520 in a non-facility setting with national GPCI: (6.85 + 4.86 + 1.49) × $33.4009 ≈ $440.89. The same code in a facility setting pays about $440.89 because facility PE RVU (4.86) replaces office PE RVU.
What changes by locality
GPCI moves 38520 non-facility payment from $393.87 to $543.5 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 38520?
6.85. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 38520 in 2026?
About $440.89 non-facility ($440.89 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (6.85) and malpractice RVU stay fixed; only practice expense changes (4.86 office vs 4.86 facility). That is the entire office-vs-facility payment gap.