CPT 38792 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 38792 by major payers:

$77.40

$83.68

$92.71

$116.32
| 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 38792 | ||||||
United | 38792 | $574.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $315.00 | 1922141647 - RIVER NORTH SAME DAY SURGERY LLC, NORTHWESTERN MEDICINE SURGERY CENTER RIVER NORTH | 364091497 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $350.00 | 1629016555 - SURGICAL ASSOCIATES NORTHWEST, PC, RAINIER SURGICAL CENTER | 911996643 - (WA) SURGICAL ASSOCIATES NORTHWEST, PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $906.00 | 1295776920 - ROSE AMBULATORY SURGERY CENTER LP | 200415436 - (CO) ROSE AMBULATORY SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $350.00 | 1447329990 - SEMMES-MURPHEY CLINIC PC, SEMMES MURPHEY SURGERY CENTER | 620642575 - (TN) SEMMES-MURPHEY CLINIC PC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $634.00 | 1215990627 - WESTSIDE SURGERY CENTER LLC, WESTSIDE SURGERY CENTER LTD | 593026856 - (FL) WESTSIDE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $91.59 | 1033190129 - MAE PHYSICIANS SURGERY CENTER, LLC | 640914895 - (MS) MAE PHYSICIAN'S SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $688.00 | 1053714758 - TEXAS PRECISION SURGERY CENTER | 471332895 - (TX) TEXAS PRECISION SURGERY CENTER L | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $1446.00 | 1508871211 - TEXAS DIGESTIVE DISEASE CENTER, LTD | 273578014 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $531.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $574.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $175.00 | 1912412420 - GALEA CENTER, LLC., GALEA CENTER FOR ADVANCED SURGERY | 821939476 - (CA) GALEA CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $150.00 | 1841840758 - GULFSTREAM PARC ASC LLC | 843025864 - (TX) GULFSTREAM PARC ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $71.00 | 1356646715 - ZACHARY ASC PARTNERS, LLC, ZACHARY ASC PARTNERS, LLC | 273854435 - (LA) ZACHARY ASC PARTNERS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38792 | $688.00 | 1891450805 - NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | 364920288 - (CO) NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | CO | 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 38792 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38792 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 38792 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38792. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38792 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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