Summary & Overview
CPT 38531: Femoral/Inguinal Lymph Node Excision, Lymphadenectomy
CPT code 38531 designates a surgical femoral/inguinal lymph node excision (lymphadenectomy) in which the surgeon incises the groin/femoral area and removes all or part of one or more lymph nodes. This code is used for definitive surgical removal of lymphatic tissue in the groin and is relevant across oncologic, infectious, and diagnostic care pathways where nodal sampling or clearance is indicated. Nationally, accurate coding of this procedure affects surgical quality tracking, resource allocation, and claims processing for inpatient and outpatient surgical settings.
Key payers covered in related analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise presentation of what the code represents clinically, the typical sites of service, common modifiers associated with surgical coding, and the context needed for billing and documentation. The publication outlines benchmark considerations, common billing scenarios, and clinical context such as indications for lymphadenectomy and expected surgical settings. Where specific payer coverage or reimbursement benchmarks are not provided in the input, the document indicates that data is not available.
Billing Code Overview
CPT code 38531 describes a surgical procedure in which the provider makes an incision over the groin and femoral region, dissects down to the lymphatic tissue, and removes all or part of one or more lymph nodes. This procedure is a surgical lymphadenectomy of the femoral/inguinal region.
Service type: Surgical procedure — lymph node excision/lymphadenectomy
Typical site of service: Operating room or ambulatory surgical center with a procedure focused on the groin/femoral region
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 56-year-old individual presenting with a suspicious palpable inguinal mass or clinically enlarged femoral lymph nodes discovered during oncologic staging for lower-extremity or pelvic malignancy (for example, melanoma of the lower leg, vulvar carcinoma, or penile cancer). Preoperative evaluation includes history and physical, imaging (ultrasound, CT or PET/CT) demonstrating abnormal lymph node(s), appropriate laboratory testing, and informed consent for excisional/focal lymph node removal. The procedure is performed in an operating room or ambulatory surgical center under regional or general anesthesia. The surgeon makes an incision over the groin/femoral region, dissects through subcutaneous tissue to identify the lymph node basin, and removes one or more lymph nodes for diagnostic pathology (sentinel or regional node excision) or therapeutic purposes. Specimens are labeled and sent for histopathology, and hemostasis is achieved prior to layered closure. Postoperative care includes wound assessment, pain control, instructions for activity and drainage monitoring, and pathology follow-up for oncologic management decisions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal, uncomplicated service | Use when procedure performed without complications or unusual circumstances |
22 |