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See a sample rate comparisonCPT 38999 Fee Schedule
Last Verified: October 2026
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.
Unlisted Proc Hemic Or Lymphatic System, Unlisted Procedure Hemic Or Lymphatic System
| 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 | 51 - Multiple procedures RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 38999 |
| Medicaid Fee Schedule | $472.21 median of the 3 states in the free preview · View Medicaid rates for 38999 |
National average reimbursement for CPT 38999 by major payers:
$1,130.84
$160.01
$1,179.38
$938.80
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CPT 38999
5 of 25 sample ratesHigher to lower in this preview
Waverley Surgery Center LLC, Waverley Surgery Center
Waverley Surgery Center, L.P.
$2,239.00Published rateNewport Beach Surgery Center, LLC, Newport Beach Surgery Center
Newport Beach Surgery Center LLC
$706.00Published rateAlliance Surgery Center At Sandy Springs LLC
$500.00Published rateMacon Outpatient Surgery, LLC
$175.00Published rateCec Surgical Services, LLC
Cec Surgical Services LLC
$80.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 38999 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38999 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 38999 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 38999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38999 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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