Commercial Insurance Rates and Coding for Lymphedema Procedures: The Current State of Confusion and Need for Consensus. Over the past century, the surgical treatment of lymphedema has evolved from excisional operations to microsurgical restoration of lymphatic circulation with physiologic procedures: lymphovenous bypass (LVB) and vascularized lymph node transplant (VLNT). Coding for lymphedema procedures has not kept pace with advances in surgical treatment. Purpose: To examine variation in commercial payer-negotiated rates for the spectrum of CPT codes that may be used for lymphedema procedures.