CPT 38500 Surgery - Hemic/Lymphatic

How Much Does Biopsy/removal Lymph Nodes Cost?

Also known as: Biopsy/removal lymph nodes (CPT 38500)

Biopsy of a lymph node by removing it completely (excisional biopsy).

The total estimated cost of Biopsy/removal Lymph Nodes (CPT 38500) is $825 to $1,547, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $246.

Total Estimated Cost of Care

$825 — $1,547

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$246
Hospital Facility Fee
$737
Anesthesia (est.)
$49
Important: The physician fee of $246 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$246
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$369
Non-facility setting

Patient Guide: Biopsy/removal Lymph Nodes

What you need to know before your appointment

What to Expect

Under local or general anesthesia, the surgeon makes an incision and removes an enlarged lymph node. The tissue is sent to a lab for analysis.

How Long Does It Take?

30-60 minutes

Common Reasons Doctors Order This

Enlarged lymph node evaluation, lymphoma diagnosis, cancer staging, infection evaluation

How to Prepare

Fast if general anesthesia is planned. Inform your doctor about blood thinners. Stitches will need removal in 7-14 days.

Procedures Commonly Done Together

These procedures are frequently performed alongside Biopsy/removal lymph nodes

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How to Reduce Your Cost for Biopsy/removal lymph nodes

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($369) differs from the facility rate ($246). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

3.70
Work RVU
2.75
Practice Expense RVU
0.90
Malpractice RVU
11.06
Total RVU

Payment = Total RVU (11.06) x CF ($33.40) = $369

Frequently Asked Questions

How much does Biopsy/removal lymph nodes cost?

The Medicare facility rate for Biopsy/removal lymph nodes is $246. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Biopsy/removal lymph nodes cost without insurance?

Without insurance, the cost of Biopsy/removal lymph nodes can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Biopsy/removal lymph nodes?

Most commercial health insurance plans and Medicare cover Biopsy/removal lymph nodes when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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