CPT 38573 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 • AS - PA/NP/CNS assistant at surgery • 52 - Reduced Services |
| Complexity Level | High |
National average reimbursement for CPT 38573 by major payers:
$1,526.84
$1,589.41
$1,566.26
$1,967.76
| 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 38573 | ||||||
United | 38573 | $2266.00 | 1376546721 - DULANEY EYE INSTITUTE, LLC | 521886840 - (MD) DULANEY EYE INSTITUTE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $1950.00 | 1043391188 - SKIN SURGERY CENTER PS, SKIN SURGERY CENTER | 911954101 - (WA) SKIN SURGERY CENTER P. S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $3496.00 | 1104373315 - BRENTWOOD SURGERY CENTER, LLC, BRENTWOOD SURGERY CENTER | 200533890 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $1032.00 | 1740277821 - TRANSSOUTH HEALTH CARE PLLC, TRANSSOUTH HEALTH CARE PC | 621453805 - (TN) TRANSSOUTH HEALTH CARE, P.C. | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $8535.00 | 1346403854 - THE EMORY CLINIC INC, EMORY ORTHOPAEDIC SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $7888.00 | 1215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $3977.00 | 1912906157 - SOUTHERN SURGERY CENTER, LLC | 522200293 - (MS) SOUTHERN SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $1050.00 | 1164871075 - CENTRAL ARIZONA GI & LIVER INSTITUTE LLC | 812583508 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $2133.00 | 1003110792 - CREVE COEUR SURGERY CENTER, LLC, CITY PLACE SURGERY CENTER | 273332421 - (MO) CREVE COEUR SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $9182.00 | 1598096802 - MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC, MEMORIAL HERMANN MEMORIAL VILLAGE SURGERY CENTER | 264276930 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $6087.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $2256.00 | 1700843208 - FAYETTEVILLE AMBULATORY SURGERY CENTER LIMITED PARTNERSHIP, FAYETTEVILLE AMBULATORY SURGERY CENTER | 561754482 - (NC) FAYETTEVILLE AMBULATORY SURGERY | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $819.00 | 1164404638 - CAMPUS EYE GROUP ASC INC, SURGICENTER ANESTHESIA ASSOCIATES | 223047283 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $18000.00 | 1023159860 - THOUSAND OAKS SURGERY CENTER, LLC | 272867027 - (CA) THOUSAND OAKS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38573 | $940.00 | 1780292110 - BUCKEYE SOUTH LLC, BUCKEYE SURGERY CENTER | 832419523 - (AZ) BUCKEYE SOUTH LLC | AZ | 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 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 | 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) |
| 38746-CPT | Moderate | Thoracic Lymphadenectomy By Thoracotomy, Mediastinal And Regional Lymphadenectomy (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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