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See a sample rate comparisonCPT 38564 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 Surgery To Stage Cancer, Surgery To Remove Specific Lymph Nodes From The Body Or Abdomen. Tissue From The Nodes Can Be Used To Identify The Stage Of A Disease. This Procedure Commonly Supports A Treatment Plan.
| 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 80 - Assistant surgeon |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $662.34 national non-facility rate (2026) · View Medicare rates for 38564 |
| Medicaid Fee Schedule | $523.585 median of the 8 states in the free preview · View Medicaid rates for 38564 |
National average reimbursement for CPT 38564 by major payers:
$915.72
$930.64
$973.19
$1,133.07
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CPT 38564
5 of 25 sample ratesHigher to lower in this preview
Voorhees Nj Endoscopy Asc LLC, The Endo Center At Voorhees
The Voorhees Nj Endoscopy Asc LLC
$4,300.00Published rateFvosa Surgical Partners, LLC, Orthopedic & Sports Surgery Center
Fvosa Surgical Partners, LLC
$1,055.00Published rateSurgcenter Of Southern Maryland, LLC
Surgcenter Of Southern Maryland
$936.00Published ratePlainfield Surgery Center, LLC
Plainfield Surgery Center LLC
$700.00Published rateCollin County Asc, Lp, Medfinity Health Surgery Center - Plano
$200.00Published rate
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See a sample payer proposalCPT 38564 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38564 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 38564 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 |
|---|---|---|
| 38562-CPT | Moderate | Lymph Surgery To Stage Cancer, Surgery To Remove Specific Lymph Nodes From The Body Or Abdomen. Tissue From The Nodes Can Be Used To Identify The Stage Of A Disease. This Procedure Commonly Supports A Treatment Plan. |
| 38564-CPT | Moderate | Lymph Surgery To Stage Cancer, Surgery To Remove Specific Lymph Nodes From The Body Or Abdomen. Tissue From The Nodes Can Be Used To Identify The Stage Of A Disease. This Procedure Commonly Supports A Treatment Plan. |
| 38740-CPT | Moderate | Axillary Lymphadenectomy Superficial |
| 38900-CPT | Moderate | Sentinel Lymph Node Procedure, Intraoperative Identification (Eg Mapping) Of Sentinel Lymph Node(S) Includes Injection Of Non-Radioactive Dye When Performed (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38564. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38564 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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