CPT 38573 Pelvic & Aortic Lymphadenectomy Reimbursement | OpenPayer

Summary & Overview

CPT 38573: Pelvic and Aortic Lymphadenectomy with Omentectomy, Minimally Invasive

CPT code 38573 denotes a minimally invasive combined pelvic and aortic lymphadenectomy with omentectomy and peritoneal/diaphragmatic washings, commonly performed in oncologic surgery to remove involved lymphatic tissue and obtain staging specimens. Nationally, this code captures a complex surgical oncology service with implications for hospital resource use, surgical quality measurement, and cancer staging pathways. Payers commonly covering this service in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of the clinical scope of the procedure, typical sites of service, and the role this code plays in cancer care delivery. The publication summarizes common billing modifiers and related administrative considerations, benchmarks for utilization when available, and the clinical context in which the procedure is used (oncologic staging, cytoreduction, and diagnostic sampling). It also highlights policy and payer considerations relevant to coverage and claims adjudication for complex minimally invasive oncologic procedures. Data not available in the input is clearly identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 38573lymphadenectomyomentectomyminimally invasive surgerysurgical oncologypelvic surgeryaortic lymph node samplingperitoneal washingsoperating roomambulatory surgery center

Billing Code Overview

CPT code 38573 describes a comprehensive minimally invasive pelvic and aortic lymphadenectomy with omentectomy and associated peritoneal and diaphragmatic washings. The procedure involves excision of all lymph nodes on both sides of the pelvis through minimally invasive skin incisions, sampling of aortic lymph nodes, collection of peritoneal and diaphragmatic washings, excision of the omentum, and optional biopsies of the peritoneal serosa. The intent is removal of diseased lymphatic tissue and tissue sampling to assess or prevent further spread of malignancy.

Service type: Major surgical oncologic procedure (minimally invasive pelvic and aortic lymphadenectomy with omentectomy and washings)
Typical site of service: Inpatient or outpatient surgical suite with capability for minimally invasive abdominal or pelvic surgery (operating room/ambulatory surgery center)

Clinical & Coding Specifications

Clinical Context

A 59-year-old female with newly diagnosed high-grade epithelial ovarian carcinoma is scheduled for a staging and cytoreductive procedure. Preoperative imaging demonstrated adnexal mass with enlarged pelvic and para-aortic lymph nodes. Intraoperatively, the gynecologic oncology surgeon performs a minimally invasive (laparoscopic or robotic-assisted) bilateral pelvic lymphadenectomy (38573) with sampling of para-aortic (aortic) nodes, peritoneal and diaphragmatic washings, and omentectomy. Peritoneal biopsies of suspicious serosal surfaces are taken. The clinical workflow includes preoperative consent and staging discussion, anesthesia induction, placement of laparoscopic ports, systematic removal of pelvic lymph node tissue bilaterally through small incisions, collection of washings and biopsies, excision of the omentum, specimen labeling and submission to pathology, postoperative recovery in PACU, and coordination of adjuvant oncology follow-up and staging documentation for cancer registry reporting.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier used / default	Rarely appended; indicates no special modifier applies when billing the primary procedure.
`11`

CPT 38572: Laparoscopic Pelvic and Aortic Lymphadenectomy

CPT-38570-LAPAROSCOPIC-RETROPERITONEAL-LYMPH-NODE-SAMPLING

CPT 38570: Laparoscopic Retroperitoneal Lymph Node Sampling

CPT-38589-LYMPHATIC-SYSTEM-UNLISTED-PROCEDURE

CPT 38589: Unlisted Procedure, Lymphatic System

CPT-38571-LAPAROSCOPIC-BILATERAL-PELVIC-LYMPHADENECTOMY

CPT 38571: Laparoscopic Bilateral Pelvic Lymphadenectomy

Taxonomy Code	Specialty	Notes
`208800000X`	Gynecologic Oncology	Primary specialty performing staging, lymphadenectomy, and omentectomy for ovarian and related malignancies.
`208600000X`	Obstetrics & Gynecology	General gynecologic surgeons frequently perform pelvic node dissections in benign and malignant cases.
`207V00000X`	Surgical Oncology	Surgical oncologists perform complex oncologic lymphadenectomies and cytoreductive procedures.
`208000000X`	General Surgery	General surgeons may perform pelvic and para-aortic node dissections in certain multidisciplinary cases.
`3336C0002X`	Thoracic Surgery (occasionally)	Involvement when diaphragmatic or upper peritoneal access requires thoracic expertise; less common.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C56.9`	Malignant neoplasm of ovary, unspecified	Primary indication for staging pelvic and para-aortic lymphadenectomy and omentectomy.
`C57.9`	Malignant neoplasm of other and unspecified female genital organs	Used when tumor origin within female pelvis is malignant but unspecified; may prompt lymph node sampling.
`C79.3`	Secondary malignant neoplasm of ovary	Metastatic disease to ovary where nodal assessment and cytoreduction are part of management.
`C77.3`	Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes	Indicates pelvic nodal metastasis; correlates with pelvic lymphadenectomy for diagnosis or treatment.
`D07.9`	Carcinoma in situ of unspecified female genital organ	Occasionally part of preoperative diagnostic spectrum though less common for full lymphadenectomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`38571`	Lymph node excision, pelvic, unilateral or bilateral, open or laparoscopic — limited	May be used when only a limited pelvic lymphadenectomy is performed rather than a complete bilateral dissection; sometimes performed in staged approaches.
`58999`	Unlisted procedure, pelvis and perineum (eg, for procedures not otherwise specified)	Used only if a specific component of staging or cytoreduction performed is not represented by existing codes; requires operative report documentation.
`49000`	Unlisted laparoscopy procedure, abdomen, peritoneum and omentum	Used if an uncommon laparoscopic peritoneal/omental procedure not otherwise coded is performed in conjunction.
`58150`	Total abdominal hysterectomy, for uterus and cervix, with or without removal of tubes, ovaries	Often performed in the same operative setting during staging/cytoreductive surgery for gynecologic malignancy.
`58720`	Salpingo-oophorectomy, unilateral or bilateral	Commonly performed concurrently when removing adnexal primary tumor during staging and lymphadenectomy.

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