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See a sample rate comparisonHealthcare 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 | AS - PA/NP/CNS assistant at surgery 52 - Reduced Services |
| Complexity Level | High |
| Medicare Fee Schedule | $1,080.85 national non-facility rate (2026) · View Medicare rates for 38573 |
| Medicaid Fee Schedule | $845.535 median of the 8 states in the free preview · View Medicaid rates for 38573 |
National average reimbursement for CPT 38573 by major payers:

$1,526.84

$1,589.41

$1,566.26

$1,909.47
Choose a payer to see a sample of rates for CPT 38573.
Chandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center
Capital Endoscopy LLC
Capital Endoscopy & Surgery Center
Murrieta Specialty Surgery Center PC A Professional Corporation
Pioneer Ambulatory Surgery Center, LLC
Pioneer Ambulatory Surgery Center LLC
Buckeye South LLC, Buckeye Surgery Center
Buckeye South LLC
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 38573 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38573 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 38573 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 |
|---|---|---|
| 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 |
| 38746-CPT | Moderate | Thoracic Lymphadenectomy By Th, Thoracic Lymphadenectomy By Thoracotomy Mediastinal And Regional Lymphadenectomy (List Separately In Addition To Code For Primary Procedure) |
| 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 38573. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38573 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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