CPT 38200 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Hemic and Lymphatic Systems |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 38200 |
National average reimbursement for CPT 38200 by major payers:
$175.36
$181.04
$177.64
$218.68
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 38200 | ||||||
United | 38200 | $170.00 | 1629647268 - UNITED VASCULAR OF HUNTSVILLE, LLC | 832575902 - (AL) UNITED VASCULAR OF HUNTSVILLE | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $366.00 | 1912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $333.00 | 1871591248 - NOVAMED SURGERY CENTER OF NASHUA, LLC, NASHUA EYE SURGERY CENTER | 770618679 - (NH) NOVAMED SURGERY CENTER OF NASHUA LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $250.00 | 1124026422 - CHARLESTON ENT ASSOCIATES, LLC, SURGERY CENTER OF CHARLESTON | 582281023 - (SC) CHARLESTON ENT ASSOCIATES, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $70.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $87.00 | 1225107014 - COMMONWEALTH EYE CLINIC INC | 611140257 - (KY) COMMONWEALTH EYE CLINIC INC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $1500.00 | 1386624815 - QUALITY SURGICENTER LLC | 421480973 - (IA) QUALITY SURGICENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $566.00 | 1215091087 - CORPUS CHRISTI SURGICARE LTD, CHRISTUS SPOHN TEXAS ORTHOPEDIC CENTER OF EXCELLENCE | 753049514 - (TX) CORPUS CHRISTI SURGICARE LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $1029.00 | 1487399168 - WILLOW PARK ENDOSCOPY CENTER, LLC | 881643733 - (TX) WILLOW PARK ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $697.00 | 1336148360 - BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER, LLC, BOULDER SURGERY CENTER | 201391702 - (CO) BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $361.00 | 1437155207 - TEXARKANA SURGERY CENTER LP | 752807190 - (TX) TEXARKANA SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $130.00 | 1124092945 - ROCKLEDGE FL ENDOSCOPY ASC LLC, SPACE COAST ENDOSCOPY CENTER | 200073131 - (FL) ROCKLEDGE FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $121.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $113.00 | 1578643607 - PAIN CENTER LLC | 331048492 - (AR) THE PAIN CENTER OF JONESBORO, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38200 | $662.00 | 1952364499 - DENTON REGIONAL AMBULATORY SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DENTON | 200270605 - (TX) DENTON REGIONAL AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 38200 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38200 code is part of the Surgery services used for Surgical Procedures on the Hemic and Lymphatic Systems. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 38200 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 38200-CPT | Low | Injection Procedure For Splenoportograph |
| 38204-CPT | Low | Management Of Recipient Hematopoietic Progenitor Cell Donor Search And Cell Acquisition |
| 38205-CPT | Low | Blood-Derived Hematopoietic Progenitor Cell Harvesting For Transplantation, Per Collection; Allogenic |
| 38206-CPT | Low | Blood-Derived Hematopoietic Progenitor Cell Harvesting For Transplantation, Per Collection; Autologous |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38200 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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