CPT® Code 38745

An axillary lymphadenectomy is a surgical procedure that involves the complete removal of axillary lymph nodes, which are critical components of the lymphatic system located in the armpit area. This procedure is typically indicated in cases where there is a need to assess or treat conditions such as breast cancer, where lymph nodes may harbor cancerous 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 underneath the muscle, and level III nodes are found above the muscle. During the procedure, a surgical 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 facilitate the removal of the lymph nodes. The procedure aims to excise not only the lymph nodes but also the surrounding fat pad, typically resulting in the removal of 15 to 25 axillary nodes. This thorough excision is crucial for ensuring that any cancerous or suspicious tissue is completely removed. After the lymph nodes are excised, a drain is placed to prevent fluid accumulation, and the surgical wound is subsequently closed. It is important to note that CPT® Code 38740 should be used for the excision of superficial lymph nodes, which includes those in level I, while CPT® Code 38745 is designated for the complete removal of axillary lymph nodes encompassing levels I through III.