CPT 38227 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 38227 |
National average reimbursement for CPT 38227 by major payers:
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| 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 38227 | ||||||
United | 38227 | $994.26 | 1750358453 - CENTER FOR DIGESTIVE HEALTH LTD | 391738062 - (WI) THE CENTER FOR DIGESTIVE HEALTH LTD | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $524.00 | 1073818654 - ROYAL OAK SURGICAL CENTER, LLC, ROYAL OAK SURGICAL CENTER PLLC | 320323562 - (MI) ROYAL OAK SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $1595.00 | 1760568273 - WALLA WALLA CLINIC, INC., WALLA WALLA CLINIC AMBULATORY SURGERY CENTER | 910862542 - WALLA WALLA CLINIC, INC. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $523.00 | 1750420147 - INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER, ISPM ASC | 205896580 - (GA) INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $177.00 | 1497831523 - BOSTON IVF, INC., THE SURGERY CENTER OF WALTHAM | 42921956 - (MA) BOSTON IVF, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $1600.00 | 1023370251 - O'CONNOR BUILDING SURGERY CENTER LLC | 455437708 - (CA) OCONNOR BUILDING SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $2575.00 | 1083776314 - CROZER-CHESTER MEDICAL CENTER | 811507712 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $363.00 | 1396700753 - HALCYON LASER & SURGERY CENTER, INC. | 770410936 - (CA) HALCYON LASER SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $400.00 | 1598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY | 472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $560.00 | 1457813107 - SURGEON'S SURGERY CENTER SORELLE PLLC | 831414422 - (NV) SURGEONS SURGERY CENTER SORELLE PLLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $360.00 | 1396277208 - ELITE SURGERY CENTER, LLC | 820836081 - (CA) ELITE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $340.00 | 1629262274 - THE SURGERY CENTER OF THE VILLAGES, LLC, THE SURGERY CENTER OF THE VILLAGES | 208291654 - (FL) THE SURGERY CENTER OF THE VILLAGES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $1167.00 | 1336649565 - ADVANCED SURGICAL CARE OF ST. LOUIS, LLC | 823086965 - (MO) ADVANCED SURGICAL CARE OF ST LOUIS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $7400.00 | 1689053050 - BELTWAY SURGERY CENTERS, LLC, MULTISPECIALTY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38227 | $600.00 | 1902852841 - MIDTOWN UROLOGY SURGICAL CENTER, PC | 582022094 | GA | 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 38227 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38227 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 38227 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 |
|---|---|---|
| 38227-CPT | Moderate | Chimeric Antigen Receptor T-Cell (Car-T) Therapy; Receipt And Preparation Of Car-T Cells For Administration |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38227. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38227 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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