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See a sample rate comparisonCPT 38505 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Lymph Node Surgery, Surgery On A Lymph Node. The Node May Be Removed Entirely Or A Sample Of The Tissue May Be Taken For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Hemic and Lymphatic Systems |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $170.35 national non-facility rate (2026) · View Medicare rates for 38505 |
| Medicaid Fee Schedule | $133.62 median of the 8 states in the free preview · View Medicaid rates for 38505 |
National average reimbursement for CPT 38505 by major payers:
$188.30
$168.86
$209.72
$138.37
Compare published rates across providers.
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CPT 38505
5 of 25 sample ratesHigher to lower in this preview
Childrens National Medical Center
Childrens Hospital
$4,617.00Published rateNeil Anand
Integrated Imaging Consultants, LLC
$222.60Published rateGabrielle Pham-Che
Town Center Orthopaedic Associates, P.C.
$176.50Published rateEdward Reason
Delphi Hospitalist Services LLC
$130.65Published rateNitin Mariwalla
Nitin Mariwalla Md PLLC
$92.01Published rate
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See a sample payer proposalCPT 38505 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38505 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 38505 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 |
|---|---|---|
| 38500-CPT | Moderate | Lymph Node Surgery, Surgery On A Lymph Node. The Node May Be Removed Entirely Or A Sample Of The Tissue May Be Taken For Testing (Biopsy). |
| 38505-CPT | Low | Lymph Node Surgery, Surgery On A Lymph Node. The Node May Be Removed Entirely Or A Sample Of The Tissue May Be Taken For Testing (Biopsy). |
| 38510-CPT | Moderate | Deep Lymph Node Surgery, Surgery On A Lymph Node Located Deep In The Neck (Cervical). The Node May Be Removed Entirely Along With Nearby Tissue. Alternatively A Sample Of The Tissue May Be Taken For Testing (Biopsy). |
| 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 38505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38505 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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Frequently Asked Questions
To find out the cost of a medical procedure, you can start by contacting your insurance provider to understand your coverage, deductibles, and co-pays. For specific fee schedule information based on CPT codes and your location, you can use tools like Payerprice, which offers a fee schedule lookup tool for users to search with CPT codes and specific locations.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for understanding healthcare costs because they precisely identify the service rendered, allowing for consistent billing and pricing across different providers and payers. When looking up costs, knowing the CPT code helps you find accurate price information for that specific service.
For specific fee schedule information, especially when you have a CPT code and your location, you can use specialized tools. Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to find relevant pricing information.
Healthcare costs can vary significantly due to several factors including differences in hospital or clinic operating costs, physician experience and specialization, regional market rates, insurance negotiation power, and the specific equipment or technology used. Even within the same city, prices can fluctuate widely between different facilities.
To understand your medical bills, you can first review the Explanation of Benefits (EOB) from your insurance company, which details what they paid and what you owe. You can also contact the billing department of your healthcare provider for clarification. For upfront cost transparency and to compare prices, especially with a CPT code and location, tools like Payerprice can be very helpful.