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See a sample rate comparisonHealthcare 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 | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | UA PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 38207 |
| Medicaid Fee Schedule | $33.48 median of the 8 states in the free preview · View Medicaid rates for 38207 |
National average reimbursement for CPT 38207 by major payers:

$54.42

$61.74

$76.14

$76.04
Choose a payer to see a sample of rates for CPT 38207.
Senate Street Surgery Center LLC, Clarian Health Partners Inc Mbr
Senate Street Surgery Center LLC
Piccard Surgery Center, LLC
Ski Ambulatory Surgical Centers, LLC
Ski Ambulatory Surgical Centers LLC
Greenbrier Clinic Surgery Center
Stephanie Preston
Deaconess Hospital Inc
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Rate Benchmarking
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See a sample payer proposalCPT 38207 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38207 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 38207 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 |
|---|---|---|
| 38204-CPT | Low | Managmnt Of Recipient Hematopoie Progenitor Cell Donor Search &, Management Of Recipient Hematopoietic Progenitor Cell Donor Search And |
| 38205-CPT | Low | Stem Cell Collection, Collection Of Blood-Derived Stem Cells From A Donor. The Stem Cells Will Be Used To Regenerate Bone Marrow Or An Immune System Damaged By Chemotherapy Or Radiation. |
| 38206-CPT | Low | Stem Cell Collection, Collection Of Blood-Derived Stem Cells From A Donor. The Stem Cells Will Be Used To Regenerate Bone Marrow Or An Immune System Damaged By Chemotherapy Or Radiation. |
| 38207-CPT | Low | Transplnt Prep Of Hematopoie Progenitor Cells; Cryopreserva, Transplant Preparation Of Hematopoietic Progenitor Cells; Cryopreserva |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38207. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38207 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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