CPT 38225 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 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 38225 |
National average reimbursement for CPT 38225 by major payers:
$N/A
$N/A
$N/A
$N/A
| 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 38225 | ||||||
United | 38225 | $983.00 | 1558879684 - DELAWARE RIVER SURGICAL SUITES, LLC | 822713553 - (PA) BUCKS COUNTY SURGICAL SUITES | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $1954.00 | 1770048225 - BAPTIST SURGERY AND ENDOSCOPY CENTERS, LLC | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $735.00 | 1396454963 - ST LUKES SURGICAL CENTER INC, ST. LUKE'S SURGICAL AT WESLEY CHAPEL | 592407224 - (FL) ST LUKES SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $1741.00 | 1427282771 - UPSTATE ORTHOPEDICS AMBULATORY SURGERY CENTER LLC, UPSTATE ORTHOPEDICS ASC | 770711020 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $385.00 | 1548254402 - LIVE OAK ENDOSCOPY CENTER, LLC | 10709517 - (FL) LIVE OAK ENDOSCOPY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $643.00 | 1760473425 - BECKLEY SURGERY CENTER, INC | 550764318 - (WV) BECKLEY SURGERY CENTER INC | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $668.00 | 1477178879 - SURGCENTER OF FAYETTEVILLE, LLC | 844038708 - (AR) SURGCENTER OF FAYETTEVILLE LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $328.00 | 1871536763 - ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD., ROCKFORD ENDOSCOPY CENTER | 363081482 - (IL) ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $2153.00 | 1689651481 - TETON OUTPATIENT SERVICES LLC | 841412817 - (WY) TETON OUTPATIENT SERVICES LLC | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $266.00 | 1821336371 - EYECARE SURGERY CENTER, LLC | 461073660 - (MS) EYECARE SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $542.00 | 1730249327 - AMBULATORY SURGERY CENTER OF WNY | 161554732 - (NY) AMBULATORY SURGERY CENTER OF WNY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $441.00 | 1528340213 - UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC | 453017917 - (NJ) UNIVERSITY CENTER FOR AMBULATORY SURGERY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $405.00 | 1801869292 - AMSURG NORTHERN KENTUCKY GI LLC, ST. ELIZABETH PHYSICIANS ENDOSCOPY CENTER | 621719097 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $417.00 | 1982783270 - DERMATOLOGY SURGERY CENTER, LLC, LASER & SKIN SURGERY CENTER | 593680567 - (SC) DERMATOLOGY SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38225 | $1274.00 | 1225579295 - SANTA BARBARA OUTPATIENT SURGERY CENTERS LLC, SANTA BARBARA SURGERY CENTER | 371846158 | CA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 38225 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38225 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 38225 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 |
|---|---|---|
| 38225-CPT | Moderate | Chimeric Antigen Receptor T-Cell (Car-T) Therapy; Harvesting Of Blood-Derived T Lymphocytes For Development Of Genetically Modified Autologous Car-T Cells, Per Day |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38225 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 38225) and we'll show you how you compare in 15 minutes or less.