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See a sample rate comparisonCPT 38572 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.
Lymph Node Biopsy Or Removal, Lymph Node Surgery Aided By A Scope (Laparoscopy). The Procedure May Remove One Or More Lymph Nodes Or Take A Sample Of Lymph Tissue 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 21 - Inpatient Hospital |
| Common Modifiers | 51 - Multiple procedures AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | $825.67 national non-facility rate (2026) · View Medicare rates for 38572 |
| Medicaid Fee Schedule | $656.19 median of the 8 states in the free preview · View Medicaid rates for 38572 |
National average reimbursement for CPT 38572 by major payers:
$1,144.21
$1,237.35
$1,282.36
$1,494.88
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CPT 38572
5 of 25 sample ratesHigher to lower in this preview
Saint Luke'S North Surgery Center, LLC
Saint Lukes North Surgery Center LLC
$12,219.00Published rateAria Health Torresdale -Spu
Jefferson Health-Northeast
$5,654.00Published rateNorth Pacific Dermatology Ps
$3,439.00Published rateRush Surgicenter At The Professional Building Ltd. Partnership, Rush Surgicenter Ltd. Partnership
Rush Surgicenter, Ltd.
$1,924.00Published rateMcdowell Ambulatory Surgery Center LLC
$795.00Published rate
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See a sample payer proposalCPT 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 | Lymph Node Biopsy Or Removal, Lymph Node Surgery Aided By A Scope (Laparoscopy). The Procedure May Remove One Or More Lymph Nodes Or Take A Sample Of Lymph Tissue For Testing (Biopsy). |
| 38572-CPT | High | Lymph Node Biopsy Or Removal, Lymph Node Surgery Aided By A Scope (Laparoscopy). The Procedure May Remove One Or More Lymph Nodes Or Take A Sample Of Lymph Tissue For Testing (Biopsy). |
| 38573-CPT | High | Laps Pelvic Lymphadec, Laparoscopy Surgical With Bilateral Total Pelvic Lymphadenectomy And Peri Aortic Lymph Node Sampling Peritoneal Washings Peritoneal Biopsy Ies Omentectomy And Diaphragmatic Washings Including Diaphragmatic And Other Serosal Biopsy Ies When Performed |
| 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 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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