Summary & Overview
CPT 38724: Excision of Cervical Lymph Nodes (Neck Dissection)
CPT code 38724 denotes a surgical excision of cervical lymph nodes with removal of diseased soft tissue, performed with preservation of key neck structures such as the spinal accessory nerve, jugular vein, and sternocleidomastoid muscle. This procedure is clinically important for managing regional nodal disease and preventing further spread of malignancy or infection. Nationally, utilization of neck dissection codes like 38724 informs surgical oncology capacity, operative resource planning, and payer medical necessity determinations.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical intent and typical settings for the service, a breakdown of common billing considerations, and context for how this procedure fits within surgical oncology and otolaryngology care pathways. The publication covers benchmarks for service type and site of service, common modifier usage (listed separately), and policy considerations relevant to coverage and prior authorization practices. Data not provided in the input are noted as unavailable where applicable. The content is intended for clinicians, coding and billing professionals, and payer policy teams seeking a clear, national-level overview of CPT code 38724 and its clinical role.
Billing Code Overview
CPT code 38724 describes an excision of cervical lymph nodes with removal of any diseased soft tissue encountered in the neck. The procedure emphasizes careful dissection to identify and preserve the spinal accessory nerve, the jugular vein, and the sternocleidomastoid muscle while excising diseased nodes to limit regional spread of disease.
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Service type: Surgical excision of cervical lymph nodes (lymphadenectomy/neck dissection)
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Typical site of service: Hospital operating room or ambulatory surgical center, performed under appropriate anesthesia
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents with a progressively enlarging, firm, non-tender mass in the right lateral neck after a recent biopsy confirmed metastatic squamous cell carcinoma. Workup includes contrast-enhanced neck CT showing multiple enlarged level II–IV lymph nodes with extracapsular extension. The multidisciplinary team determines a therapeutic selective neck dissection is indicated to remove involved cervical lymph nodes and reduce regional tumor burden. The patient is admitted to an outpatient surgical unit, undergoes general anesthesia, and receives intraoperative nerve monitoring to preserve the spinal accessory nerve. The surgeon dissects and removes pathologic lymphatic tissue in the cervical region while identifying and preserving the internal jugular vein and the sternocleidomastoid muscle. Specimens are sent to pathology for staging. Postoperative care includes pain control, wound care, assessment of shoulder function, and coordination of adjuvant radiation oncology if indicated. Typical site of service: hospital outpatient surgical suite or inpatient operating room. Service type: therapeutic surgical excision — selective/modified radical neck dissection of the cervical lymph nodes with preservation of neural and vascular structures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normally scheduled office/outpatient procedure | When billed services represent the usual, uncomplicated service provided by the surgeon (often used in commercial billing). |