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 |
| Medicare Fee Schedule | View Medicare rates for 38572 |
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 | $1924.00 | 1619013455 - RUSH SURGICENTER AT THE PROFESSIONAL BUILDING LTD. PARTNERSHIP, RUSH SURGICENTER LTD. PARTNERSHIP | 363853026 - (IL) RUSH SURGICENTER, LTD. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $4535.00 | 1801899687 - TRINITY SURGERY CENTER LLC, BAYCARE SURGERY CENTER | 20656933 - (FL) TRINITY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $5885.66 | 1003807835 - LAKEVIEW SURGERY CENTER LC | 421516120 - (IA) LAKEVIEW SURGERY CENTER LC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $2853.00 | 1205998648 - REGIONAL EYE ASSOCIATES, INC, SURGICAL EYE CENTER OF MORGANTOWN | 550740986 - REGIONAL EYE ASSOCIATES, INC. | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $5500.00 | 1972153997 - EASTERN PENNSYLVANIA ENDOSCOPY CENTER, LLC | 842257961 - (PA) EASTERN PENNSYLVANIA ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $6492.00 | 1831180272 - ADVANCED ENDOSCOPY CENTER LLC | 861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $2266.00 | 1346205176 - CORAL DESERT SURGERY CENTER LLC | 710875262 - (UT) CORAL DESERT SURGERY CENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $1331.00 | 1265488563 - SYRACUSE ASC, LLC, SPECIALTY SURGERY CENTER OF CNY | 161549512 - (NY) SPECIALTY SURGERY CENTER OF CNY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $2765.00 | 1205808938 - ABILENE EYE ASC LP, ABILENE CATARACT AND REFRACTIVE SURGERY CENTER | 621678444 - (TX) ABILENE EYE ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $3563.00 | 1801952783 - AMBULATORY SURGICENTER OF DOWNERS GROVE | 364106726 - (IL) AMBULATORY SURGICENTER OF DOWNERS GROVE | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $4170.00 | 1184686164 - SHORE AMBULATORY SURGICAL CENTER, LLC | 223778333 - (NJ) SHORE AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $5318.97 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $1562.00 | 1053301473 - BAKER AMBULATORY SURGERY CENTER | 710839283 - (AR) BAKER AMBULATORY SURGERY CENTER | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $5654.00 | 1407981327 - ARIA HEALTH TORRESDALE -SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38572 | $7581.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | 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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