Needle biopsy or removal of surface lymph nodes
Medicare pricing data for 11,567 providers across 52 states
This procedure has a 6.0x markup — hospitals charge $522.45 but Medicare allows only $86.97. Uninsured patients may face bills 6.0 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Needle biopsy or removal of surface lymph nodes (HCPCS code 38505) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $86.97, but hospitals typically charge $522.45 — a 6.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $86.97, your out-of-pocket cost would be approximately $17.39. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.0x more than what Medicare allows for this procedure. Medicare actually pays $68.05 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $116 | $783 | 29 | 79 | +33.7% |
| Arkansas | $110 | $379 | 92 | 334 | +26.5% |
| New York | $104 | $754 | 716 | 2,269 | +19.8% |
| Nevada | $104 | $575 | 97 | 250 | +19.7% |
| Colorado | $103 | $892 | 203 | 515 | +18.9% |
| Maryland | $102 | $350 | 209 | 822 | +17.5% |
| Nebraska | $97 | $492 | 85 | 354 | +11.8% |
| California | $97 | $663 | 1,061 | 3,612 | +11.2% |
| New Jersey | $92 | $461 | 290 | 842 | +5.4% |
| New Mexico | $91 | $590 | 67 | 238 | +5.1% |
| Florida | $91 | $594 | 739 | 2,447 | +5.0% |
| Massachusetts | $91 | $347 | 332 | 1,082 | +4.6% |
| Washington | $89 | $364 | 283 | 895 | +2.9% |
| Arizona | $89 | $677 | 212 | 770 | +2.4% |
| Connecticut | $89 | $428 | 180 | 437 | +2.1% |
| Oregon | $88 | $417 | 170 | 435 | +1.3% |
| Texas | $88 | $653 | 786 | 2,541 | +1.2% |
| District of Columbia | $87 | $410 | 50 | 142 | -0.2% |
| New Hampshire | $86 | $573 | 73 | 218 | -0.9% |
| Delaware | $86 | $250 | 36 | 155 | -1.3% |
| Utah | $85 | $258 | 89 | 259 | -1.8% |
| Hawaii | $85 | $313 | 32 | 78 | -1.9% |
| Tennessee | $85 | $463 | 241 | 756 | -1.9% |
| North Carolina | $85 | $471 | 467 | 1,234 | -2.8% |
| Kansas | $84 | $470 | 117 | 353 | -3.4% |
| Wyoming | $84 | $575 | 21 | 63 | -3.5% |
| Minnesota | $83 | $606 | 296 | 938 | -4.5% |
| Rhode Island | $83 | $337 | 48 | 138 | -4.9% |
| Illinois | $81 | $546 | 481 | 1,627 | -6.3% |
| Vermont | $81 | $746 | 22 | 87 | -6.7% |
| Virginia | $81 | $358 | 346 | 1,114 | -7.2% |
| Georgia | $80 | $590 | 308 | 815 | -7.9% |
| Wisconsin | $80 | $1,146 | 292 | 845 | -8.3% |
| Puerto Rico | $80 | $185 | 12 | 24 | -8.5% |
| Michigan | $79 | $283 | 366 | 1,026 | -8.7% |
| Maine | $79 | $277 | 63 | 122 | -8.9% |
| Pennsylvania | $79 | $342 | 539 | 1,677 | -9.1% |
| Mississippi | $78 | $360 | 88 | 285 | -9.8% |
| West Virginia | $78 | $284 | 51 | 186 | -10.6% |
| Montana | $77 | $292 | 42 | 131 | -11.2% |
| Alabama | $77 | $446 | 157 | 393 | -11.4% |
| North Dakota | $76 | $545 | 36 | 166 | -12.1% |
| Iowa | $76 | $398 | 111 | 479 | -12.9% |
| Kentucky | $75 | $341 | 128 | 392 | -13.4% |
| Louisiana | $75 | $387 | 133 | 321 | -13.7% |
| Indiana | $74 | $356 | 250 | 778 | -14.4% |
| Ohio | $74 | $404 | 415 | 1,201 | -14.9% |
| Missouri | $74 | $394 | 273 | 894 | -15.3% |
| South Dakota | $73 | $307 | 42 | 176 | -15.8% |
| Oklahoma | $72 | $363 | 121 | 365 | -16.8% |
| South Carolina | $71 | $414 | 165 | 514 | -18.1% |
| Idaho | $70 | $338 | 77 | 169 | -19.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber