CPT 38228 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 38228 |
National average reimbursement for CPT 38228 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 38228 | ||||||
United | 38228 | $604.00 | 1437801388 - FRESENIUS ACCESS CARE PHYSICIANS OF MADISON ASC LLC | 863588248 - (WI) FRESENIUS ACCESS CARE PHYSICIANS OF MADISON ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $523.00 | 1215275227 - ISPM ASC AT PIEDMONT, LLC | 455109249 - (GA) ISPM ASC AT PIEDMONT LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $2737.00 | 1295213734 - LOS GATOS SURGICAL CENTER, A CALIFORNIA LIMITED PARTNERSHIP, ENDOSCOPY CENTER OF SILICON VALLEY | 942909203 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $410.00 | 1346288032 - ENDOSCOPY CENTER AT RIDGE PLAZA LP, ENDOSCOPY CENTER AT MEDPOINT | 383656538 - (TX) ENDOSCOPY CENTER AT MED POINT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $644.00 | 1164771762 - MARYLAND SPECIALTY SURGERY CENTER, LLC | 454793230 - (MD) MARYLAND SPECIALTY SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $667.00 | 1902447386 - SEATTLE PAIN RELIEF PLLC, FEDERAL WAY AMBULATORY SURGICAL FACILITY | 455527273 - (WA) SEATTLE PAIN RELIEF PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $350.00 | 1205885746 - GLASGOW MEDICAL CENTER LLC, GLASGOW AMBULATORY SURGERY CENTER | 510320926 - (DE) GLASGOW MEDICAL CENTER, LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $487.00 | 1447225503 - BAPTIST DESOTO SURGERY CENTER, LP | 200804946 - (MS) BAPTIST DESOTO SURGERY CENTER LP | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $100.00 | 1013403161 - AKDHC SURGERY CENTER, LLC | 753052504 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $1100.00 | 1881850386 - THE CORVALLIS CLINIC PC | 931221257 - (OR) THE CORVALLIS CLINIC, P.C. | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $108.00 | 1710047188 - ARROWHEAD ENDOSCOPY AND PAIN MANAGEMENT CENTER LLC, ARROWHEAD ENDOSCOPY CENTER. | 205706445 - (AZ) ARROWHEAD ENDOSCOPY AND PAIN MAN | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $624.00 | 1194970418 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $501.00 | 1154369114 - CHRISTUS SANTA ROSA PASC-SAN ANTONIO LLC, CHRISTUS SURGERY CENTER - ALAMO HEIGHTS | 412092141 - (TX) CHRISTUS SRPASC - SAN ANTONIO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $1274.00 | 1902302961 - HILL COUNTRY SURGERY CENTER, LLC, SURGERY CENTER OF BOERNE | 352599588 - (TX) HILL COUNTRY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38228 | $100.00 | 1043222417 - COTTONWOOD DAY SURGERY CENTER | 860757762 - (AZ) COTTONWOOD DAY SURGERY CENTER, INC. | AZ | 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 38228 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38228 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 38228 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 |
|---|---|---|
| 38228-CPT | Moderate | Chimeric Antigen Receptor T-Cell (Car-T) Therapy; Car-T Cell Administration, Autologous |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38228. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38228 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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