Summary & Overview
CPT 38700: Suprahyoid Lymph Node Excision
CPT code 38700 denotes surgical excision of lymph nodes superior to the hyoid bone, a targeted lymphadenectomy for disease processes—most often neoplastic—in the upper midline neck. Nationally, this code captures procedures that can be diagnostic or therapeutic in cancer care pathways and may require more extensive dissection when metastasis involves adjacent jaw or upper neck tissues. Its use affects surgical case mix, hospital and ambulatory surgical center resource planning, and payment patterns for head and neck oncology.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on clinical indications and typical sites of service, comparative payment and utilization benchmarks where available, and operational considerations for coding and claims submission. The publication also summarizes recent policy updates or coding guidance that influence how this procedure is documented and billed. Clinicians, billing professionals, and policy analysts will gain a concise reference for the clinical scope of the code, common encounter settings, and the implications for payer reimbursement and case documentation.
Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, or payer-specific rates.
Billing Code Overview
CPT code 38700 describes surgical excision of lymph nodes located superior to the hyoid bone in the midline of the neck. The procedure typically involves removal of lymphatic tissue at the top of the hyoid bone, a small midline bone near the base of the tongue and above the thyroid. In cases of metastatic malignancy, the procedure may extend to include adjacent lymph nodes and soft tissues of the jaw and upper neck.
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Service type: Surgical lymphadenectomy of the suprahyoid/upper midline neck region
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Typical site of service: Ambulatory surgical center or hospital operating room, with potential postoperative recovery in a surgical observation or inpatient setting depending on extent of dissection and patient condition
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to head and neck surgical oncology for evaluation of suspected metastatic squamous cell carcinoma to regional lymph nodes near the hyoid bone. The patient commonly presents with a persistent lateral neck mass, dysphagia, odynophagia, or an enlarging midline submental mass. Imaging (CT or MRI of the neck) and needle biopsy (fine needle aspiration) suggest metastatic disease in level I/II nodes or an isolated node at the hyoid region. Multidisciplinary discussion with medical oncology and radiation oncology occurs preoperatively.
The clinical workflow includes preoperative assessment (history, physical, airway evaluation, and anesthesia clearance), imaging review, consent for excision of lymph nodes near the hyoid with possible extension to adjacent submandibular or upper neck tissue if intraoperative findings indicate metastasis. In the operating room, general anesthesia with endotracheal intubation is typical. The surgeon makes an incision appropriate to the location, performs meticulous dissection to excise the lymph nodes overlying the hyoid bone, and may extend the dissection to remove additional nodes or soft tissue depending on frozen section results. Hemostasis is achieved, drains may be placed based on extent of dissection, and the wound is closed. Postoperative care includes pain control, monitoring for airway compromise, drain management, pathology review, and coordination of adjuvant therapy if malignancy is confirmed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |