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See a sample rate comparisonCPT 38381 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery On Chest Lymph Channel, Surgery To Repair A Leak In The Large Lymph Channel That Runs Down The Chest Into The Abdomen.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Hemic and Lymphatic Systems |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 51 - Multiple procedures AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | $771.56 national non-facility rate (2026) · View Medicare rates for 38381 |
| Medicaid Fee Schedule | $605.445 median of the 8 states in the free preview · View Medicaid rates for 38381 |
National average reimbursement for CPT 38381 by major payers:
$1,003.10
$1,081.05
$1,114.15
$1,300.03
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CPT 38381
5 of 25 sample ratesHigher to lower in this preview
Metro Specialty Surgery Center, LLC
Metro Specialty Surgery Center LLC
$2,668.00Published rateFountain Valley Surgery Center, LLC
$1,121.00Published rateSurgcenter Of Glen Burnie, Surgcenter Of Glen Burnie, LLC
Surgcenter Of Glen Burnie, LLC
$936.00Published rateCollege Heights Endoscopy Center LLC
$416.00Published rateDigestive Health Complex
$200.00Published rate
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See a sample payer proposalCPT 38381 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38381 code is part of the Surgery services used for Surgical Procedures on the Hemic and Lymphatic Systems. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 38381 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 38380-CPT | Moderate | Surgery On Chest Lymph Channel, Surgery To Repair A Leak In The Large Lymph Channel That Runs Down The Chest Into The Abdomen. |
| 38381-CPT | High | Surgery On Chest Lymph Channel, Surgery To Repair A Leak In The Large Lymph Channel That Runs Down The Chest Into The Abdomen. |
| 38382-CPT | Moderate | Surgery On Chest Lymph Channel, Surgery To Repair A Leak In The Large Lymph Channel That Runs Down The Chest Into The Abdomen. |
| 38792-CPT | Low | Inject Proc; Radioactive Tracer For Id Of Sentinel, Injection Procedure; Radioactive Tracer For Identification Of Sentinel |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38381. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38381 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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