CPT code 38206: Stem cell collection, autologous, blood-derived2026 Medicare rate & RVUs in Maine
Reports collection of a patient’s own blood-derived stem cells for transplantation, commonly by apheresis during preparation for an autologous transplant.
CMS doesn’t publish an office rate for 38206 in Maine.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 38206 covers
This service represents collection of a patient’s own blood-derived stem cells for a planned transplant. Collection commonly occurs by apheresis in a hospital or outpatient collection unit after the transplant team arranges mobilization of cells into the bloodstream. A transplant physician, hematologist, or apheresis team may be involved. This is distinct from harvesting marrow directly from bone.
Report 38206 per collection, with documentation identifying the patient’s own cells, the transplant purpose, and the collection session. CMS restricts payment to specific circumstances. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in the same session, the highest-valued procedure is paid in full and others receive the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 38206 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | Unavailable | $65.08 |
| Southern Maine, ME | Unavailable | $66.22 |
How the 38206 rate is calculated
Each of 38206’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 38206
RVUs × geographic indexes × conversion factor
Work1.46
1.46 RVUs× 1.000 GPCI
Practice expense0.47
0.47 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
2.0200
Conversion factor
$33.4009
Medicare rate
$67.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38206
The CMS indicators that decide how 38206 is paid alongside other services.
CMS payment indicators · 38206
Stem cell collection, autologous, blood-derived
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
38206 without 51 · national facility
$67.47
Stem cell collection, autologous, blood-derived
38206-51 · Second procedure: 50%
$33.74
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
38206 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 38205Stem cell collectionAllogeneic, blood-derived
- Use 38206 for the patient’s own blood-derived cells; use 38205 when the cells come from an allogeneic donor.
- 38232Bone marrow harvestAutologous transplant harvest
- 38232 represents harvesting autologous marrow directly. 38206 represents collecting the patient’s blood-derived cells, commonly through apheresis.
- 38225CAR-T cell collectionBlood-derived T lymphocytes
- 38225 covers collection of blood-derived T lymphocytes for CAR-T therapy. 38206 is for autologous stem-cell collection for transplantation.
- 38207Stem cell cryopreservationFreezing-based preservation
- 38207 represents cryopreservation of stem cells, a processing service; 38206 represents the collection itself.
38206 billing questions
How is 38206 different from 38205?
38206 is for collecting the patient’s own blood-derived cells. Use 38205 when the blood-derived cells come from an allogeneic donor.
Is 38206 reported per collection day or per transplant?
It is reported per collection, not per transplant. Documentation should support each collection billed.
Does 38206 describe a bone marrow harvest?
No. It describes blood-derived cell collection, commonly by apheresis. Autologous marrow harvest is represented by 38232.
Can stem-cell processing be reported separately?
38207 identifies cryopreservation, a processing service rather than collection. Report it when that service is performed and documentation supports it.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for 38206. Assistant-at-surgery payment requires documentation of medical necessity.
What documentation supports payment?
Document that the collected cells are the patient’s own blood-derived cells, the transplant purpose, and the collection session. CMS restricts payment to specific circumstances.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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