CPT 38230 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 38230 by major payers:
$292.35
$311.02
$314.72
$365.19
| 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 38230 | ||||||
United | 38230 | $775.00 | 1932719754 - RESTORATIVE SURGERY CENTER LLC, IPS SURGERY CENTER, LLC | 862855145 - (MO) RESTORATIVE SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $999.00 | 1124026422 - CHARLESTON ENT ASSOCIATES, LLC, SURGERY CENTER OF CHARLESTON | 582281023 - (SC) CHARLESTON ENT ASSOCIATES, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $426.00 | 1487043386 - DENTAL SURGICENTER OF LOUISVILLE INC | 464672803 - (KY) DENTAL SURGICENTER | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $1886.00 | 1518359181 - ARAPAHOE SURGICENTER, LLC | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $553.00 | 1467844068 - WEST ANNAPOLIS SURGERY CENTER, LLC | 472474153 - (MD) WEST ANNAPOLIS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $390.00 | 1881962348 - CENTER FOR SPINE AND PAIN MEDICINE PC, CSPM CHATTANOOGA ASC | 341976829 - CENTER FOR SPINE AND PAIN MEDICI | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $1763.00 | 1225064876 - ROCK HILL SURGERY CENTER, LLC, CAROLINA SURGICAL CENTER | 752562111 - (SC) ROCK HILL SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $800.00 | 1467559625 - WINCHESTER EYE SURGERY CENTER, LLC | 203055242 - (VA) WINCHESTER EYE SURGERY CENTER, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $575.00 | 1588203723 - SOUTHWEST CARDIOVASCULAR INTERVENTIONAL CENTER, LLC | 832560085 - (AZ) SOUTHWEST CARDIOVASCULAR INTERVENTIONAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $785.00 | 1235683798 - ASSOCIATED SURGICAL CENTER LLC | 813492018 - (IL) ASSOCIATED SURGICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $1179.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $281.00 | 1235117052 - ALLEGANY AMBULATORY SURGERY CENTER LLC | 522268598 - (MD) ALLEGANY AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $543.00 | 1629576848 - CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC, CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC | 822281290 - (SC) CAROLINA INTERVENTIONAL PAIN INSTITUTE LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $1214.00 | 1306249453 - MARK FROMER, LLC, EYE SURGERY CENTERS OF NEW YORK | 274212773 - (NY) MARK FROMER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 38230 | $3159.00 | 1649534843 - SURGERY CENTER OF WASILLA, LLC | 455023852 - (AK) SURGERY CENTER OF WASILLA LLC | AK | 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 38230 vs. Other Surgical Procedures on the Hemic and Lymphatic Systems Codes
The CPT 38230 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 38230 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 |
|---|---|---|
| 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 |
| 38230-CPT | Moderate | Bone Marrow Harvesting For Transplantation; Allogeneic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 38230. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 38230 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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