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See a sample rate comparisonCPT 38520 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.
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).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Hemic and Lymphatic Systems |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $440.89 national non-facility rate (2026) · View Medicare rates for 38520 |
| Medicaid Fee Schedule | $349.89 median of the 8 states in the free preview · View Medicaid rates for 38520 |
National average reimbursement for CPT 38520 by major payers:
$626.14
$612.31
$628.49
$753.31
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CPT 38520
5 of 25 sample ratesHigher to lower in this preview
Newport Bay Surgery Center, LLC
$3,599.00Published rateCascade Surgicenter, LLC
Cascade Surgicenter LLC
$1,827.00Published rateThe Center For Aesthetic Surgery LLC
$1,213.00Published rateDeer Creek Surgery Center, LLC
$1,109.00Published rateLaser Surgery Holding Company, Ltd
Laser Surgery Holding Company Lt
$454.00Published rate
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See a sample payer proposalCPT 38520 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38520 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 38520 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 |
|---|---|---|
| 38520-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). |
| 38525-CPT | Moderate | Deep Lymph Node Surgery, Surgery On A Lymph Node Located In The Deeper Tissues Of The Body. The Node May Be Removed Entirely Along With Nearby Tissue. Alternatively A Sample Of The Tissue May Be Taken For Testing (Biopsy). |
| 38530-CPT | Moderate | Deep Lymph Node Surgery, Surgery On A Lymph Node Located In The Deeper Tissues Of The Body. 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 38520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38520 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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