CPT 38760 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 38760 by major payers:
$1,143.30
$1,105.12
$1,159.61
$1,377.12
| 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 38760 | ||||||
United | 38760 | $2206.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $2388.00 | 1053764779 - SURGCENTER OF ST. LUCIE, LLC | 475425011 - (FL) SURGCENTER OF ST. LUCIE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $1815.00 | 1912906157 - SOUTHERN SURGERY CENTER, LLC | 522200293 - (MS) SOUTHERN SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $1542.00 | 1619469244 - RUSH OAK BROOK SURGERY CENTER, LLC | 371832312 - (IL) RUSH OAK BROOK SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $850.00 | 1972214682 - CEI PHYSICIANS PSC, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $700.00 | 1083898605 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC, MIDSOUTH PAIN TREATMENT CENTER, LLC | 261545635 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $2307.00 | 1831420694 - TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC | 263531997 - (FL) TITUSVILLE CENTER FOR SURGICAL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $3608.00 | 1710231642 - ADVANCED REGIONAL SURGERY CENTER, LLC | 461072979 - (IN) ADVANCED REGIONAL SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $991.00 | 1073621512 - DIGESTIVE DISEASE CENTER | 880291959 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $1258.00 | 1174938344 - SPECIALTY SURGERY CENTER, LLC | 455554765 - (MS) SPECIALTY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $4388.00 | 1598417875 - ESSENTIA HEALTH SURGERY CENTERS-DULUTH LLC, ESSENTIA HEALTH SURGERY CENTER-MILLER HILL | 874339770 - (MN) ESSENTIA HEALTH SURGERY CENTERSDULUTH LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $3000.00 | 1407812498 - LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP | 364119522 - (IL) LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $2007.00 | 1013539709 - BSC BILTMORE LLC | 850820003 - (AZ) BSC BILTMORE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $3348.22 | 1508213810 - ALEGENT CREIGHTON HEALTH, CHI HEALTH AMBULATORY SURGERY CENTER AT MIDLANDS | 470757164 - ALEGENT CREIGHTON HEALTH | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38760 | $1375.00 | 1790862183 - CATARACT AND LASER CENTER OF THE NORTH SHORE, LLC | 43388939 - (MA) CATARACT AND LASER CENTER OF THE NORTH SHORE LLC | MA | 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 38760 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38760 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 38760 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 |
|---|---|---|
| 38531-CPT | Moderate | Biopsy Or Excision Of Lymph Node(S); Open Inguinofemoral Node(S) |
| 38760-CPT | High | Inguinofemoral Lymphadenectomy, Superficial, Including Cloquet's Node (Separate Procedure) |
| 38765-CPT | High | Inguinofemoral Lymphadenectomy, Superficial, In Continuity With Pelvic Lymphadenectomy, Including External Iliac, Hypogastric, And Obturator Nodes (Separate Procedure) |
| 38780-CPT | High | Retroperitoneal Transabdominal Lymphadenectomy, Extensive, Including Pelvic, Aortic, And Renal Nodes (Separate Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38760. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38760 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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