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See a sample rate comparisonCPT 38792 Fee Schedule
Last Verified: October 2026
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.
Inject Proc; Radioactive Tracer For Id Of Sentinel, Injection Procedure; Radioactive Tracer For Identification Of Sentinel
| 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 | LT - Left side of body RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $82.17 national non-facility rate (2026) · View Medicare rates for 38792 |
| Medicaid Fee Schedule | $64.58 median of the 8 states in the free preview · View Medicaid rates for 38792 |
National average reimbursement for CPT 38792 by major payers:
$77.40
$83.68
$92.71
$60.28
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CPT 38792
5 of 25 sample ratesHigher to lower in this preview
Indiana Endoscopy Centers LLC
$4,613.00Published rateAdvanced Surgery Center Of Metairie LLC
Advanced Surgery Center Of Metairie
$555.00Published rateWestern Washington Endoscopy Centers LLC, Puyallup Endoscopy Center
Western Washington Endoscopy Centers LLC
$155.00Published rateTower Oaks Surgery Center, LLC
Tower Oaks Surgery Center LLC
$119.00Published ratePhysicians Clinic Inc
$84.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 38790-CPT | Low | Injection Procedure For Lymphangiography |
| 38792-CPT | Low | Inject Proc; Radioactive Tracer For Id Of Sentinel, Injection Procedure; Radioactive Tracer For Identification Of Sentinel |
| 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) |
| 38999-CPT | High | Unlisted Proc Hemic Or Lymphatic System, Unlisted Procedure Hemic Or Lymphatic System |
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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized five-character alphanumeric codes used by medical professionals to describe medical, surgical, and diagnostic services. They are essential for billing and processing healthcare claims.
To find the cost of a specific medical procedure based on your specific situation, it is recommended to use Payerprice's fee schedule lookup tool. This tool allows users to search with a CPT code and specific location, providing relevant pricing information.
CMS stands for the Centers for Medicare & Medicaid Services. It is a federal agency within the United States Department of Health and Human Services that administers Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). CMS plays a significant role in healthcare policy, regulation, and setting payment rates for services covered by these programs.
Payerprice offers a specialized fee schedule lookup tool designed to help users find healthcare costs. It allows you to search using a specific CPT code and location, providing a direct and convenient way to understand potential prices for medical services relevant to your unique situation.
To use Payerprice's fee schedule lookup tool, you would typically visit their platform. There, you can input the specific CPT code for the medical service you are interested in and your desired location. The tool will then provide you with fee schedule information tailored to your search criteria.