Home / Medicare fees / 38746

38746 Remove thoracic lymph nodes

What 38746 is

CMS fee schedule short descriptor: Remove thoracic lymph nodes.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 38746 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)4.020.811.025.85$195.40
Facility (hospital, ASC)4.020.811.025.85$195.40

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 38746 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 38746? These codes are bundled into it

38746 is a Column 1 code in 29 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair
11047Dbrdmt bone each addl1 - modifier may bypassCheck pair
32551Insertion of chest tube1 - modifier may bypassCheck pair
32601Thoracoscopy diagnostic1 - modifier may bypassCheck pair
32606Thoracoscopy w/bx med space1 - modifier may bypassCheck pair
32607Thoracoscopy w/bx infiltrate1 - modifier may bypassCheck pair
32608Thoracoscopy w/bx nodule1 - modifier may bypassCheck pair
32609Thoracoscopy w/bx pleura1 - modifier may bypassCheck pair
32674Thoracoscopy lymph node exc0 - no modifier bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
38500Biopsy/removal lymph nodes1 - modifier may bypassCheck pair
38530Biopsy/removal lymph nodes1 - modifier may bypassCheck pair
38531Open bx/exc inguinofem nodes1 - modifier may bypassCheck pair
39000Exploration of chest1 - modifier may bypassCheck pair
39010Exploration of chest1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
97597Dbrdmt opn wnd 1st 20 cm/<1 - modifier may bypassCheck pair
97598Dbrdmt opn wnd addl 20cm/<1 - modifier may bypassCheck pair
97602Wound(s) care non-selective1 - modifier may bypassCheck pair

38746 is bundled into these codes

38746 appears as a Column 2 code in 8 active edits. Reported with one of these Column 1 codes on the same date of service, 38746 is the code that denies.

Column 1 codeShort descriptionModifier indicator
43107Removal of esophagus0Check pair
43108Removal of esophagus0Check pair
43113Removal of esophagus0Check pair
43116Partial removal of esophagus0Check pair
43121Partial removal of esophagus0Check pair
43124Removal of esophagus0Check pair
43286Esphg tot w/laps moblj0Check pair
43288Esphg thrsc moblj0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.