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What the whole sentinel lymph node biopsy (underarm) costs

Removing the first lymph nodes a breast cancer drains to. Every bill that usually comes with it, who sends it, and where each number comes from.

Price it for your ZIP, hospital or insurerRates by insurer

Partial estimate. Add-on codes often billed with it (38900) are not included. The totals below run low.

Medicare, national amounts, 2026

BillSurgery centerHospital outpatient
Facility$1,603$4,000
Surgeon$431$431
Anesthesia$150$150
Before surgery (typical)$177$177
After surgery (typical)$70$35
Total$2,431$4,793

National Medicare amounts (payment-area and wage adjustments at 1.0). Facility: OPPS Addendum B, July 2026 (national unadjusted rate); local = rate × (0.6 × wage index + 0.4); ASC Addendum AA, July 2026 (national rate); local = rate × (0.5 × wage index + 0.5); device-intensive (J8) codes keep the device portion unadjusted; FY 2026 IPPS final rule CMS-1833-F, Table 5; standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons. Surgeon: CMS Physician Fee Schedule CY2026 (RVU26D). Anesthesia: CMS base units × the CY2026 anesthesia conversion factor, with an assumed case time. An educational estimate, not a quote.

Line by line (surgery center)

Questions

How much does a sentinel lymph node biopsy (underarm) cost in total, with every bill?

At national Medicare rates for 2026, the whole sentinel lymph node biopsy (underarm) comes to about $2,431 in a surgery center and about $4,793 in a hospital outpatient, counting the facility, the surgeon, anesthesia and typical care before and after. Commercial plans usually pay more; local rates differ by area.

Why do I get separate bills for a sentinel lymph node biopsy (underarm)?

The surgery center bills for the facility; the surgeon's group bills for the operation (Surgeon, CPT 38525, about $431 from Medicare nationally); the anesthesia group bills by base units plus time (about $150 at our default time); labs, imaging, pathology and therapy each come from their own provider.

What does the surgeon's fee include?

90-day global: the fee covers the operation plus the visit the day before and routine follow-up visits for 90 days.