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CPT 38562: Pelvic/Aortic Lymphadenectomy for Cancer Staging

CPT code 38562 represents surgical excision of pelvic and/or aortic lymph nodes (lymphadenectomy) performed to determine cancer stage in the pelvis. This code is important nationally because lymphadenectomy influences staging, prognosis, and subsequent cancer-directed treatment decisions across multiple malignancies that involve pelvic lymphatic drainage.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, plus coverage and billing considerations commonly encountered across major commercial and public payers. The report summarizes typical sites of service, coding scope, and common payer patterns where available.

The publication provides operational benchmarks for service utilization, summarizes relevant policy trends and coverage considerations, and situates CPT code 38562 within perioperative cancer care workflows. Content is intended for billing managers, surgical departments, and policy analysts seeking a national overview of how pelvic/aortic lymphadenectomy is categorized and processed in payer systems. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 38562 describes an excisional lymphadenectomy of pelvic and/or aortic lymph nodes performed to assess cancer staging in the pelvis. The procedure involves surgical removal of lymph nodes from the pelvic region or adjacent to the aorta to obtain tissue for pathologic evaluation and staging.

Service Type: Surgical - Lymphadenectomy for cancer staging

Typical Site of Service: Hospital operating room or ambulatory surgical center, with inpatient or outpatient surgical admission depending on clinical factors and surgical extent.

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CPT 38562: Pelvic/Aortic Lymphadenectomy for Cancer Staging

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Billing Code Overview

Service Type: Surgical - Lymphadenectomy for cancer staging

Typical Site of Service: Hospital operating room or ambulatory surgical center, with inpatient or outpatient surgical admission depending on clinical factors and surgical extent.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 58-year-old woman with newly diagnosed endometrial adenocarcinoma scheduled for staging surgery. Preoperative imaging shows no distant metastasis but possible pelvic lymph node involvement. In the operating room under general anesthesia, the gynecologic oncology surgeon performs a total hysterectomy with bilateral salpingo-oophorectomy and excises pelvic and/or para-aortic lymph nodes (38562) to obtain tissue for pathological staging. Intraoperative steps include identification of vascular landmarks, careful dissection along the iliac vessels and aortic bifurcation, hemostasis, and specimen orientation for the pathologist. The procedure may be open or performed via minimally invasive approach; specimens are sent fresh for histopathology and may be submitted for frozen section if intraoperative decisions depend on nodal status. Typical site of service is an acute care hospital operating room or ambulatory surgery center when clinically appropriate. Common concurrent perioperative services include anesthesia, surgical pathology, and postoperative inpatient recovery with nursing and postoperative pain management.

Coding Specifications

Modifier	Description	When to Use
`11`	Unrelated evaluation and management service by the same physician on the same day of the procedure	Use when a significant, separate E/M service is provided on the same day as `38562` unrelated to the surgical procedure.
`22`	Increased procedural services	Use when the lymphadenectomy requires substantially greater work than typical (e.g., extensive adhesiolysis, unexpected anatomy).
`24`	Unrelated E/M service during a postoperative period	Use when an unrelated E/M visit occurs during the global period after `38562`.
`50`	Bilateral procedure	Use if bilateral pelvic lymphadenectomy is reported and payer requires a bilateral modifier (note: some payers use modifier `50`, others require modifier `59` or use bilateral indicators).
`51`	Multiple procedures	Use when `38562` is performed with additional distinct surgical procedures during the same operative session.
`52`	Reduced services	Use when the lymphadenectomy is intentionally partially reduced or not completed as described by `38562`.
`53`	Discontinued procedure	Use when the procedure is terminated after anesthesia start due to extenuating circumstances before completion.
`59`	Distinct procedural service	Use to indicate a distinct procedural service if another procedure might be considered bundled; helpful when coding concomitant procedures in separate anatomic regions.
`62`	Two surgeons	Use when a second surgeon performs distinct surgical work during the lymphadenectomy.
`63`	Procedure performed on infants less than 4 kg	Use for neonatal cases meeting the weight criterion, if applicable.
`78`	Return to the operating room for a related procedure during the postoperative period	Use if patient returns to OR for complications related to the initial lymphadenectomy.
`79`	Unrelated procedure or service during the postoperative period	Not in the provided modifier list; omitted.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an accredited nonphysician provider assists intraoperatively per payer rules.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Use when reporting anesthesia services tied to this operative procedure under medical direction rules.

Taxonomy Code	Specialty	Notes
208100000X	Obstetrics & Gynecology	Gynecologic oncologists commonly perform pelvic/para-aortic lymphadenectomy.
2080P0206X	Gynecologic Oncology	Subspecialty that frequently performs extensive cancer staging including `38562`.
208100000X	General Surgery	General surgeons may perform lymphadenectomy in pelvic/retroperitoneal cancer cases.
207Q00000X	Surgical Oncology	Surgical oncologists perform nodal dissections for staging of pelvic malignancies.
2086S0122X	Urology	Urologic oncologists may perform pelvic lymph node dissections for urologic cancers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C54.1`	Malignant neoplasm of endometrium	Endometrial cancer commonly requires pelvic/para-aortic lymphadenectomy for staging.
`C56.9`	Malignant neoplasm of ovary, unspecified	Ovarian malignancies may require lymph node evaluation during debulking and staging.
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Cervical cancer staging can include pelvic lymphadenectomy to determine nodal spread.
`C79.3`	Secondary malignant neoplasm of ovary and pelvic peritoneum	Metastatic disease to pelvic nodes may prompt node excision for diagnosis.
`C80.1`	Personal history of malignant neoplasm of uterus	History may prompt staging or surveillance procedures including node assessment.
`D39.1`	Neoplasm of uncertain behavior of ovary	When behavior is uncertain, lymphadenectomy may be performed during definitive surgery to guide management.
`N83.2`	Torsion of ovary, ovarian pedicle	Not typically an indication for systematic lymphadenectomy; included here only if concurrent tumor is found intraoperatively — however this code is less commonly associated.
`R91.8`	Other nonspecific abnormal findings of breast imaging	Not directly related; Data not available in the input."

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57522`	Radical hysterectomy, with or without removal of tube(s), with or without removal of ovary(s); with pelvic and/or para-aortic lymphadenectomy (separate procedure)	Performed concurrently when `38562` is part of a radical hysterectomy and nodes are removed as part of staging.
`58150`	Total abdominal hysterectomy (correction of uterus), with or without removal of tube(s), with or without removal of ovary(s)	Often performed same session; `38562` reported in addition when lymphadenectomy is separately identifiable.
`38525`	Biopsy or excision of lymph node(s); open, superficial	May be used for superficial node excision distinct from deep pelvic/para-aortic dissection coded by `38562`.
`38792`	Injection procedure for sentinel lymph node identification (e.g., radiotracer or dye)	Performed before `38562` when sentinel node mapping guides selective lymphadenectomy.
`88305`	Surgical pathology, gross and microscopic examination	Pathology CPT commonly billed for processing lymph node specimens removed during `38562`.

CPT 38564: Retroperitoneal Lymph Node Excision for Cancer Staging

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Unrelated evaluation and management service by the same physician on the same day of the procedure	Use when a significant, separate E/M service is provided on the same day as `38562` unrelated to the surgical procedure.
`22`	Increased procedural services	Use when the lymphadenectomy requires substantially greater work than typical (e.g., extensive adhesiolysis, unexpected anatomy).
`24`	Unrelated E/M service during a postoperative period	Use when an unrelated E/M visit occurs during the global period after `38562`.
`50`	Bilateral procedure	Use if bilateral pelvic lymphadenectomy is reported and payer requires a bilateral modifier (note: some payers use modifier `50`, others require modifier `59` or use bilateral indicators).
`51`	Multiple procedures	Use when `38562` is performed with additional distinct surgical procedures during the same operative session.
`52`	Reduced services	Use when the lymphadenectomy is intentionally partially reduced or not completed as described by `38562`.
`53`	Discontinued procedure	Use when the procedure is terminated after anesthesia start due to extenuating circumstances before completion.
`59`	Distinct procedural service	Use to indicate a distinct procedural service if another procedure might be considered bundled; helpful when coding concomitant procedures in separate anatomic regions.
`62`	Two surgeons	Use when a second surgeon performs distinct surgical work during the lymphadenectomy.
`63`	Procedure performed on infants less than 4 kg	Use for neonatal cases meeting the weight criterion, if applicable.
`78`	Return to the operating room for a related procedure during the postoperative period	Use if patient returns to OR for complications related to the initial lymphadenectomy.
`79`	Unrelated procedure or service during the postoperative period	Not in the provided modifier list; omitted.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an accredited nonphysician provider assists intraoperatively per payer rules.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Use when reporting anesthesia services tied to this operative procedure under medical direction rules.

Taxonomy Code	Specialty	Notes
208100000X	Obstetrics & Gynecology	Gynecologic oncologists commonly perform pelvic/para-aortic lymphadenectomy.
2080P0206X	Gynecologic Oncology	Subspecialty that frequently performs extensive cancer staging including `38562`.
208100000X	General Surgery	General surgeons may perform lymphadenectomy in pelvic/retroperitoneal cancer cases.
207Q00000X	Surgical Oncology	Surgical oncologists perform nodal dissections for staging of pelvic malignancies.
2086S0122X	Urology	Urologic oncologists may perform pelvic lymph node dissections for urologic cancers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C54.1`	Malignant neoplasm of endometrium	Endometrial cancer commonly requires pelvic/para-aortic lymphadenectomy for staging.
`C56.9`	Malignant neoplasm of ovary, unspecified	Ovarian malignancies may require lymph node evaluation during debulking and staging.
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Cervical cancer staging can include pelvic lymphadenectomy to determine nodal spread.
`C79.3`	Secondary malignant neoplasm of ovary and pelvic peritoneum	Metastatic disease to pelvic nodes may prompt node excision for diagnosis.
`C80.1`	Personal history of malignant neoplasm of uterus	History may prompt staging or surveillance procedures including node assessment.
`D39.1`	Neoplasm of uncertain behavior of ovary	When behavior is uncertain, lymphadenectomy may be performed during definitive surgery to guide management.
`N83.2`	Torsion of ovary, ovarian pedicle	Not typically an indication for systematic lymphadenectomy; included here only if concurrent tumor is found intraoperatively — however this code is less commonly associated.
`R91.8`	Other nonspecific abnormal findings of breast imaging	Not directly related; Data not available in the input."

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57522`	Radical hysterectomy, with or without removal of tube(s), with or without removal of ovary(s); with pelvic and/or para-aortic lymphadenectomy (separate procedure)	Performed concurrently when `38562` is part of a radical hysterectomy and nodes are removed as part of staging.
`58150`	Total abdominal hysterectomy (correction of uterus), with or without removal of tube(s), with or without removal of ovary(s)	Often performed same session; `38562` reported in addition when lymphadenectomy is separately identifiable.
`38525`	Biopsy or excision of lymph node(s); open, superficial	May be used for superficial node excision distinct from deep pelvic/para-aortic dissection coded by `38562`.
`38792`	Injection procedure for sentinel lymph node identification (e.g., radiotracer or dye)	Performed before `38562` when sentinel node mapping guides selective lymphadenectomy.
`88305`	Surgical pathology, gross and microscopic examination	Pathology CPT commonly billed for processing lymph node specimens removed during `38562`.

CPT 38564: Retroperitoneal Lymph Node Excision for Cancer Staging

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 38562: Pelvic/Aortic Lymphadenectomy for Cancer Staging

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Billing Code Overview

OpenPayer

CPT 38562: Pelvic/Aortic Lymphadenectomy for Cancer Staging

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References