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    v1.0.30
    OpenPayerBilling CodesEndoscopy Procedures on the MediastinumCPT cpt-39401-mediastinoscopy-with-tissue-excision
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    CPT 39401: Mediastinoscopy with Excision and Biopsy

    Medicare pays $294 on average nationally for this procedure.

    CPT code 39401 describes a mediastinoscopy with excision and biopsy of one or more abnormal-appearing masses in the mediastinum; this is an operative diagnostic endoscopic procedure in which a thin rigid or flexible instrument is inserted through a small incision in the neck or upper chest to inspect the central chest cavity between and in front of the lungs and obtain tissue samples for pathologic evaluation. Service type: diagnostic surgical endoscopy with biopsy. Typical site of service: operating room, procedure suite, or other surgical setting (neck/upper chest incision access).

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with progressive cough, unexplained weight loss, and a central mediastinal mass identified on chest CT is referred for diagnostic mediastinoscopy. Pre-procedure workflow includes history and physical, coagulation assessment, informed consent, and anesthesia evaluation. The procedure is performed in an operating room or procedure suite under general anesthesia with endotracheal intubation. The surgeon makes a small incision above the sternal notch, inserts a rigid or flexible mediastinoscope into the superior mediastinum to directly visualize mediastinal structures, and obtains excisional biopsies of any suspicious lymph nodes or masses. Specimens are placed in separate, labeled containers for histopathology and microbiology. Post-procedure workflow includes airway monitoring in the PACU, chest radiograph if clinically indicated, pain control, and postoperative pathology follow-up to guide staging or therapy. Typical sites of service are hospital inpatient, hospital outpatient department, or ambulatory surgery center depending on patient stability and comorbidities.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    31505Laryngoscopy, tracheoscopy; direct, with diagnostic or therapeutic servicesMay be performed preoperatively or concurrently for airway assessment when endotracheal access or airway lesions are a concern.
    31628Bronchoscopy, rigid or flexible, with transbronchial biopsy(s), multiplePerformed alongside or as an alternative for sampling central lesions or peribronchial nodes.
    38500Biopsy or excision of lymph node(s); superficialMay be performed for accessible peripheral nodes when staging complements mediastinal sampling.
    39000Mediastinotomy (Chamberlain procedure) for biopsyAlternative open approach for anterior mediastinal masses when mediastinoscopy is not feasible.
    76942Ultrasonic guidance for needle placement (eg, biopsy)Used when ultrasound guidance assists in preoperative localization or percutaneous sampling prior to or instead of mediastinoscopy.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207V00000X
    2084P0800X
    207K00000X
    207L00000X
    246ZG0701X
    2080P0202X
    2085D0003X
    207YX0901X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    B97.29Other coronavirus as the cause of diseases classified elsewhere
    C34.11Malignant neoplasm of upper lobe, right bronchus or lung
    C34.12Malignant neoplasm of upper lobe, left bronchus or lung
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C34.91Malignant neoplasm of unspecified part of right bronchus or lung
    C34.92Malignant neoplasm of unspecified part of left bronchus or lung
    C77.9Secondary and unspecified malignant neoplasm of lymph node, unspecified
    C78.00Secondary malignant neoplasm of unspecified lung
    C78.01Secondary malignant neoplasm of right lung
    C78.7Secondary malignant neoplasm of liver and intrahepatic bile duct

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-39402-MEDIASTINOSCOPY-LYMPH-NODE-BIOPSY

    CPT 39402: Mediastinoscopy with Lymph Node Removal

    Frequently Asked Questions

    References

    1. 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. 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. 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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