CPT® Code 38740

An axillary lymphadenectomy is a surgical procedure that involves the removal of lymph nodes located in the axilla, or armpit area. This procedure is typically performed to assess or treat conditions such as cancer, particularly breast cancer, where lymph nodes may be affected by malignant cells. The axillary lymph nodes are categorized into three levels based on their anatomical location relative to the pectoralis minor muscle: level I nodes are situated below the lower edge of the pectoralis minor, level II nodes are located beneath the muscle, and level III nodes are found above the muscle. During the procedure, an incision is made in the lowest part of the axilla to access these nodes. The surgeon carefully identifies the borders of the pectoralis major and latissimus dorsi muscles, as well as the axillary vein, which is dissected from surrounding tissues to minimize damage to nearby structures. The neural structures in the axilla are also identified and protected throughout the procedure. The surgeon excises the axillary lymph nodes along with the surrounding fat pad, typically removing between 15 to 25 nodes from the area beneath the axillary vein and adjacent to the nerves and muscles. After the excision of any cancerous or suspicious tissue, a drain is placed to prevent fluid accumulation, and the surgical wound is subsequently closed. For coding purposes, the CPT® Code 38740 is used for the excision of superficial lymph nodes, specifically those in level I, while the CPT® Code 38745 is designated for the complete removal of axillary lymph nodes encompassing levels I through III.