Summary & Overview
CPT 38555: Excision of Cystic Hygroma, Deep Axillary or Neck
CPT code 38555 designates the surgical excision of a cystic hygroma located deep in the armpit or neck, a procedure that frequently requires meticulous dissection around critical nerves and blood vessels. Nationally, this code captures a specialized head, neck and axillary surgical service performed in the operating room or ambulatory surgical center and is relevant to surgical, otolaryngology, and pediatric surgical practices managing congenital lymphatic malformations. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 38555, typical settings of care, common modifiers used with surgical procedures, and the payer mix addressed in this publication. The content highlights billing and coding clarity for encounters involving deep excision of cystic hygromas, and provides national-level context for reimbursement benchmarking and policy review where available. Data not available in the input is noted where specific payer policies, ICD-10 mappings, and related codes would normally be detailed.
Billing Code Overview
CPT code 38555 describes the surgical excision of a cystic hygroma located deep in the axillary (armpit) or cervical (neck) region. The procedure involves deep dissection with potential involvement of critical nerves and blood vessels in the operative field and is performed to remove congenital lymphatic malformations that may cause functional impairment or risk of complications.
Service type: Surgical excision, deep soft tissue
Typical site of service: Operating room or ambulatory surgical center, with procedures commonly performed under general anesthesia when deep dissection and critical structure management are required.
Clinical & Coding Specifications
Clinical Context
A pediatric or adult patient presents with a congenital or acquired cystic hygroma (lymphatic malformation) located deep in the axilla or posterior/lateral neck with symptoms such as a palpable, fluctuant mass, localized pain or discomfort, visible swelling, limited shoulder/neck range of motion, or compressive symptoms (neurovascular compression, airway compromise when neck involvement is extensive). Evaluation includes focused history and physical exam, ultrasound and MRI to define extent and relationship to adjacent nerves and vessels, and preoperative anesthesia assessment.
The typical clinical workflow begins with outpatient surgical consultation by a pediatric surgeon, otolaryngologist-head & neck surgeon, or general/plastic surgeon. Imaging review and informed consent occur preoperatively. On the day of surgery the patient undergoes preop localization and marking, general anesthesia with possible nerve monitoring, and operative excision via an incision over the lesion with careful deep dissection around brachial plexus elements, spinal accessory, facial branches (if in neck), and major vascular structures. Specimens are sent to pathology. Postoperative management includes observation for bleeding, nerve dysfunction, infection, and wound care, with scheduled follow-up for healing and functional assessment. Complex resections may require intraoperative consultation (vascular or neurosurgery) and postoperative rehabilitation or speech/swallow evaluation for neck lesions affecting cranial nerves.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |