CPT 38210 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • Q1 - Routine clinical service provided in a clinical research study • UB |
| Complexity Level | Low |
National average reimbursement for CPT 38210 by major payers:
$89.90
$108.37
$125.80
$133.16
| 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 38210 | ||||||
United | 38210 | $205.00 | 1225531544 - ANNE ARUNDEL-SCA SURGICENTER, LLC | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $338.00 | 1083785398 - OLYMPIA ORTHOPAEDIC ASSOCIATES PLLC, OLYMPIA SURGERY CENTER LLC | 911674528 - OLYMPIA ORTHOPAEDIC ASSOCIATES, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $318.00 | 1740231489 - STONEGATE SURGERY CENTER LP | 201211544 - (TX) STONEGATE SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $1070.00 | 1942231204 - SURGICAL INSTITUTE, LLC | 810911558 - (NJ) SURGICAL INSTITUTE LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $555.00 | 1942507488 - GA ENDOSCOPY CENTER, LLC | 273115800 - (GA) GA ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $172.00 | 1063514107 - OHIO SURGERY CENTER LLC | 870566551 - (OH) OHIO SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $500.00 | 1164516084 - ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC | 113530475 - (NY) ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $125.00 | 1265959795 - BHATTI GI SURGERY CENTER LLC | 822151132 - (MN) BHATTI GI SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $330.00 | 1023570488 - SIGHT PARTNERS, LLC, NORTHWEST EYE SURGEONS | 833467355 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $241.00 | 1306556907 - THE VANCOUVER CLINIC INC PS, SALMON CREEK 2 AMBULATORY SURGERY CENTER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $906.00 | 1447364682 - RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $300.00 | 1174525661 - HANOVER SURGICENTER, L.L.C. | 562533573 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $506.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $304.00 | 1629458427 - CLARKSVILLE SURGICENTER, LLC | 473830244 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38210 | $140.00 | 1811914625 - PUGET SOUND GASTROENTEROLOGY, PLLC, EDMONDS ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | 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 38210 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38210 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 38210 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 |
|---|---|---|
| 38205-CPT | Low | Blood-Derived Hematopoietic Progenitor Cell Harvesting For Transplantation, Per Collection; Allogenic |
| 38208-CPT | Low | Transplant Preparation Of Hematopoietic Progenitor Cells; Thawing Of Previously Frozen Harvest Without Washing (Rvsd 1/1/04) |
| 38209-CPT | Low | Transplant Preparation Of Hematopoietic Progenitor Cells; Thawing Of Previously Frozen Harvest With Washing (Rvsd 1/1/04) |
| 38210-CPT | Low | Transplant Preparation Of Hematopoietic Progenitor Cells; Specific Cell Depletion Within Harvest, T-Cell Depletion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38210 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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