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See a sample rate comparisonCPT 38221 Fee Schedule
Last Verified: October 2026
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.
Bone Marrow Biopsy, Insertion Of A Needle To Remove A Sample Of Bone Marrow For Testing (Biopsy).
| 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 | RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $167.01 national non-facility rate (2026) · View Medicare rates for 38221 |
| Medicaid Fee Schedule | $137.78 median of the 8 states in the free preview · View Medicaid rates for 38221 |
National average reimbursement for CPT 38221 by major payers:
$199.61
$218.35
$232.77
$140.85
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CPT 38221
5 of 25 sample ratesHigher to lower in this preview
Bay Area Surgicenter, LLC, Brandon Surgery Center
Bay Area Surgicenter LLC
$4,215.00Published rateSaint Lukes South Surgery Center LLC
$1,447.00Published rateScottsdale Endoscopy Asc LLC
$953.00Published rateBaptist Desoto Surgery Center, Lp
Baptist Desoto Surgery Center Lp
$333.00Published rateBruce Alexander
Deaconess Hospital Inc
$125.26Published rate
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See a sample payer proposalCPT 38221 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38221 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 38221 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 |
|---|---|---|
| 38220-CPT | Low | Bone Marrow Biopsy, Insertion Of A Needle To Remove A Sample Of Bone Marrow For Testing (Biopsy). |
| 38221-CPT | Low | Bone Marrow Biopsy, Insertion Of A Needle To Remove A Sample Of Bone Marrow For Testing (Biopsy). |
| 38222-CPT | Moderate | Diagnostic Bone Marrow Biopsy, Diagnostic Bone Marrow Biopsy(Ies) And Aspiration(S) Toring Percutaneous Subsequent Vein(S) Treated In A Single Extremity Each Through Separate Access |
| 38230-CPT | Moderate | Bone Marrow Collection, Collection Of Bone Marrow For Transplantation. The Bone Marrow May Be Collected From A Donor Or From A Site In The Recipients Body. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38221. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38221 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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