CPT code 38222: Bone marrow exam, aspiration and biopsy2026 Medicare rate & RVUs in Connecticut

Reports diagnostic bone marrow aspiration and core biopsy performed in the same session, commonly to evaluate unexplained cytopenias, suspected marrow disease, or hematologic malignancy.

CMS RVU26DEffective Oct 1, 2026One payment locality124.2K Medicare services in 2024

In Connecticut, Medicare pays $188.57 for 38222 in the office and $65.18 when it’s performed in a hospital or facility.

$188.57Office (non-facility)
$65.18Hospital or facility
+6.5%vs the national office rate ($177.02)

Check a contract rate as a % of Medicare · 38222 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 38222 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 38222 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 38222 covers

This code covers obtaining a bone marrow aspirate and a core biopsy for diagnostic evaluation during the same session. Hematologists, oncologists, and other qualified clinicians commonly perform the sampling, often from the posterior iliac crest, in an office procedure room, hospital, or outpatient facility. The samples can help evaluate unexplained anemia or other cytopenias, suspected marrow disorders, and hematologic malignancies.

Report this code when both aspiration and biopsy are performed; use 38220 for aspiration alone and 38221 for biopsy alone. Document the indication, sampling site or sites, and performance of both techniques. CMS applies the standard multiple procedure reduction when applicable procedures are performed in the same session: the highest-valued procedure is paid in full and other procedures at 50%. For a bilateral procedure reported with modifier 50, CMS pays 150%.

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.

How Connecticut compares for 38222

Across 109 of 109 payment localities, the office rate for 38222 runs from $157.16 in Arkansas to $235.81 in San Benito County, CA. Connecticut pays $188.57. The RVUs are the same everywhere; the geographic indexes change the dollars.

38222 in Connecticut vs other payment areas
  1. Connecticut · this page$188.57
  2. Los Angeles, CA · California$200.53+$11.96
  3. Washington, DC area · District of Columbia$202.45+$13.88
  4. Miami, FL · Florida$188.83+$0.26
  5. Chicago, IL · Illinois$183.60−$4.97
  6. Manhattan, NY · New York$202.96+$14.39
  7. Alaska · Alaska$206.64+$18.07

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

38222 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$159.40$59.16
ArkansasArkansas$157.16$58.75
ArizonaArizona$172.50$61.48
Bakersfield, CACalifornia$188.30$62.74
Chico, CACalifornia$187.89$62.33
El Centro, CACalifornia$187.92$62.35
Fresno, CACalifornia$187.89$62.33
Hanford, CACalifornia$187.89$62.33

38222 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$157.16

$211.85

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
38222 office rate range by state
State / territoryOffice rate rangeLocalities
AK$206.641
AL$159.401
AR$157.161
AZ$172.501
CA$187.89–$235.8129
CO$184.691
CT$188.571
DC$202.451
DE$175.311
FL$173.67–$188.833
GA$164.26–$180.052
GU$192.451
HI$192.451
IA$163.701
ID$164.661
IL$168.51–$184.104
IN$165.601
KS$162.781
KY$162.681
LA$162.36–$170.192
MA$183.57–$202.892
MD$178.65–$202.453
ME$165.31–$174.292
MI$166.63–$175.602
MN$177.621
MO$159.53–$170.993
MS$158.391
MT$177.021
NC$167.021
ND$174.451
NE$164.631
NH$181.641
NJ$190.90–$200.412
NM$167.451
NV$176.431
NY$169.44–$207.545
OH$166.101
OK$162.581
OR$175.23–$190.642
PA$166.46–$183.872
PR$178.341
RI$181.601
SC$166.801
SD$174.141
TN$163.561
TX$165.38–$183.938
UT$169.031
VA$173.61–$202.452
VI$178.341
VT$173.621
WA$183.27–$207.152
WI$168.731
WV$162.401
WY$175.901

See 38222 in every payment locality

How the 38222 rate is calculated

Each of 38222’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 · 38222

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.40

1.40 RVUs× 1.000 GPCI

Practice expense3.77

3.77 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

5.3000

Conversion factor

$33.4009

Medicare rate

$177.02

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,724

Code
38222
Physician work
1.40
Practice expense
3.77
Malpractice
0.13

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 38222 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.40× 1.0201.4280
Practice expense3.77× 1.0774.0603
Malpractice0.13× 1.2100.1573
Total RVUs5.6456
Conversion factor× 33.4009

Office rate, Connecticut$188.57

Office: (1.4 × 1.02 + 3.77 × 1.077 + 0.13 × 1.21) × $33.4009 = $188.57

Facility: (1.4 × 1.02 + 0.34 × 1.077 + 0.13 × 1.21) × $33.4009 = $65.18

Open 38222 in the RVU calculator

Payment rules and modifiers for 38222

The CMS indicators that decide how 38222 is paid alongside other services.

CMS payment indicators · 38222

Bone marrow exam, aspiration and biopsy

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

38222 without 50 · national office

$177.02

Bone marrow exam, aspiration and biopsy

38222-50 · Bilateral: 150%

$265.53

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 38222 has changed in Connecticut

38222 · Office / nonfacility

$188.57

Effective 2026-10-01

The base rate is $6.73 higher than on 2025-10-01, moving from $181.84 to $188.57 (3.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $181.84changed to$188.57

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.44 changed to 1.40
    • Practice expense RVU 3.66 changed to 3.77
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $188.18changed to$181.84

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.70 changed to 3.66
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $185.11changed to$188.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $191.66changed to$185.11

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.67 changed to 3.70
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207
  5. January 1, 2023

    RVU23A

    $197.10changed to$191.66

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.68 changed to 3.67
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $197.57changed to$197.10

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.65 changed to 3.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $193.99changed to$197.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.39 changed to 3.65
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $190.96changed to$193.99

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.33 changed to 3.39
    • Malpractice RVU 0.10 changed to 0.11
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $189.55changed to$190.96

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.30 changed to 3.33

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    No ratechanged to$189.55

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$188.57$65.18RVU26D
2026-07-01$188.57$65.18RVU26C
2026-04-01$188.57$65.18RVU26B
2026-01-01$188.57$65.18RVU26A
2025-10-01$181.84$75.62RVU25D
2025-07-01$181.84$75.62RVU25C
2025-04-01$181.84$75.62RVU25B
2025-01-01$181.84$75.62RVU25A
2024-10-01$188.18$77.78RVU24D
2024-07-01$188.18$77.78RVU24C
2024-04-01$188.18$77.78RVU24B
2024-03-09$188.18$77.78RVU24AR
2024-01-01$185.11$76.51RVU24A
2023-10-01$191.66$79.63RVU23D
2023-07-01$191.66$79.63RVU23C
2023-04-01$191.66$79.63RVU23B
2023-01-01$191.66$79.63RVU23A
2022-10-01$197.10$81.45RVU22D
2022-07-01$197.10$81.45RVU22C
2022-04-01$197.10$81.45RVU22B
2022-01-01$197.10$81.45RVU22A
2021-10-01$197.57$82.51RVU21D
2021-07-01$197.57$82.51RVU21C
2021-04-01$197.57$82.51RVU21B
2021-01-01$197.57$82.51RVU21A
2020-10-01$193.99$85.53RVU20D
2020-07-01$193.99$85.53RVU20C
2020-04-01$193.99$85.53RVU20B
2020-01-01$193.99$85.53RVU20A
2019-10-01$190.96$85.56RVU19D
2019-07-01$190.96$85.56RVU19C
2019-04-01$190.96$85.56RVU19B
2019-01-01$190.96$85.56RVU19A
2018-10-01$189.55$85.47RVU18D
2018-07-01$189.55$85.47RVU18C
2018-04-01$189.55$85.47RVU18B
2018-01-01$189.55$85.47RVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 38222 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

38222 billing questions

When should 38222 be chosen over 38220 or 38221?

Use 38222 when diagnostic aspiration and core biopsy are both performed in the same session. Use 38220 for aspiration alone or 38221 for biopsy alone.

Can 38220 and 38221 also be reported with 38222?

Do not separately report the aspiration-only or biopsy-only code for the same sampling already represented by 38222.

How is bilateral sampling reported?

When the service is performed bilaterally, report modifier 50. CMS pays a bilateral procedure reported with modifier 50 at 150%.

What documentation supports reporting 38222?

Document the diagnostic reason, the sampling site or sites, and that both aspiration and core biopsy were performed.

Are marrow specimen interpretation services included in 38222?

38222 represents the sampling procedure. Bone marrow smear interpretation or surgical pathology examination may be separately represented by codes such as 85097 or 88305 when those services are performed and documented.

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

Show the CMS file lines behind this rate
RVUs for 38222PPRRVU2026_Oct_nonQPP.csv, line 4,724 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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