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See a sample rate comparisonCPT 38555 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.
Removal Of Lymph Tumor, Surgery To Remove A Lymph Tumor (Cystic Hygroma) From A Node Or Within The Lymph Channels. The Procedure May Involve Treatment Of Nerves And Blood Vessels.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Hemic and Lymphatic Systems |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | LT - Left side of body AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | $983.32 national non-facility rate (2026) · View Medicare rates for 38555 |
| Medicaid Fee Schedule | $770.345 median of the 8 states in the free preview · View Medicaid rates for 38555 |
National average reimbursement for CPT 38555 by major payers:
$1,370.06
$1,332.73
$1,340.78
$1,630.33
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CPT 38555
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, LLC, East Washington Surgery Center
$8,705.00Published rateThe Polyclinic, The Polyclinic Mohs Surgery
The Polyclinic, PLLC
$2,136.00Published rateSummit Health Partners LLC, Western Carolina Surgery Center
Summit Health Partners LLC
$1,323.00Published rateMountain Home Surgery Center
$950.00Published rateGem State Endoscopy
$760.00Published rate
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See a sample payer proposalCPT 38555 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38555 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 38555 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 |
|---|---|---|
| 38542-CPT | Moderate | Dissection; Deep Jugular Node(S) |
| 38550-CPT | Moderate | Removal Of Lymph Tumor, Surgery To Remove A Lymph Tumor (Cystic Hygroma) From A Node Or Within The Lymph Channels. The Procedure May Involve Treatment Of Nerves And Blood Vessels. |
| 38555-CPT | High | Removal Of Lymph Tumor, Surgery To Remove A Lymph Tumor (Cystic Hygroma) From A Node Or Within The Lymph Channels. The Procedure May Involve Treatment Of Nerves And Blood Vessels. |
| 38700-CPT | High | Suprahyoid Lymphadenectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38555. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38555 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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