CPT 38572 Fee Schedule
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.
| 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 | • None • 51 - Multiple procedures • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
National average reimbursement for CPT 38572 by major payers:
$1,144.21
$1,237.35
$1,282.36
$1,530.50
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 38572 | ||||||
United | 38572 | $10360.00 | 1205939345 - BELTWAY SURGERY CENTERS LLC, INDIANA HAND TO SHOULDER BELTWAY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $1760.00 | 1679521389 - WESLEY & KLIPPENSTEIN, PC, WESLEY OPHTHALMIC PLASTIC SURGERY CENTER | 621799761 - (TN) WESLEY & KLIPPENSTEIN, P.C. | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $2608.00 | 1932212511 - PALESTINE LASER & SURGERY CENTER PLLC | 470900270 - (TX) PALESTINE LASER SURGERY CENTER PLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $3240.00 | 1346220183 - BLACK HILLS REGIONAL EYE SURGERY CENTER, LLC | 460462601 - (SD) BLACK HILLS REGIONAL EYE SURGERY CENTER LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $9475.00 | 1144612714 - ANCHORAGE SURGICENTER, LLC | 472881055 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $3474.00 | 1093757379 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $6492.00 | 1760491385 - ENDOSCOPY CENTER OF NORTHERN OHIO, LLC | 341966846 - (OH) ENDOSCOPY CENTER OF NORTHERN OHIO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $7888.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $1500.00 | 1700369071 - ALLIANCE SURGERY CENTER AT MARIETTA, LLC | 831521891 - (GA) ALLIANCE SURGERY CENTER AT MARIETTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $3330.00 | 1093156937 - QUALITY CARE SURGERY CENTER, LLC | 462355538 - (CA) QUALITY CARE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $3335.00 | 1750378295 - BRAINERD LAKES SURGERY CENTER L L C | 200113449 - (MN) BRAINERD LAKES SURGERY CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $2911.00 | 1457465403 - VENTURE AMBULATORY SURGERY CENTER | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $2163.00 | 1528680865 - MERIDIAN SURGERY CENTER LLC | 845179604 - (MD) MERIDIAN SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $5173.00 | 1902063605 - PENN PRESBYTERIAN MEDICAL CENTER SPU | 232810852 - PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $938.00 | 1689646937 - OCALA ENDOSCOPY ASC LP, ENDOSCOPY CENTER OF OCALA | 621650750 - (FL) OCALA ENDOSCOPY ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 38572 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38572 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 38572 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 |
|---|---|---|
| 38571-CPT | Moderate | Laparoscopy;With Bilateral Total Pelvic Lymphadenectomy |
| 38572-CPT | High | Laparoscopy, Surgical; With Bilateral Total Pelvic Lymphadenectomy And Peri-Aortic Lymph Node Sampling (Biopsy), Single Or Multiple |
| 38573-CPT | High | Laparoscopy Surgical; With Bilateral Total Pelviclymphadenectomy And Peri-Aortic Lymph Node Sampling Peritoneal Washings Peritoneal Biopsy(Ies) Omentectomy And Diaphragmatic Washings Including Diaphragmatic And Other Serosal Biopsy(Ies) When Performed |
| 38720-CPT | High | Cervical Lymphadenectomy (Complete) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38572. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38572 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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