CPT code 38226: CAR T-cell preparation, for transduction2026 Medicare rate & RVUs in Missouri
Identifies preparation of T lymphocytes for transduction in the CAR T-cell process, distinct from collection, preparation for administration, and administration.
CMS doesn’t publish an office rate for 38226 in Missouri.
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 38226 covers
38226 identifies preparation of T lymphocytes for transduction in the CAR T-cell process. Transduction is the genetic modification step used to produce CAR T cells. This preparation is distinct from collecting blood-derived T lymphocytes, receiving and preparing cells for administration, and administering autologous CAR T cells. The related CAR T codes identify those other stages: 38225 for collection, 38227 for receipt and preparation for administration, and 38228 for autologous administration. The code therefore identifies a processing stage before administration, rather than collection or administration itself.
Medicare assigns this CPT code physician fee schedule status B (bundled). Medicare never pays 38226 separately; payment is included in payment for other services. The code concerns preparation of T lymphocytes for transduction, not the collection or administration stages.
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 38226 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the 38226 rate is calculated
Each of 38226’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 · 38226
RVUs × geographic indexes × conversion factor
Work0.77
0.77 RVUs× 1.000 GPCI
Practice expense0.17
0.17 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
1.0100
Conversion factor
$33.4009
Medicare rate
$33.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38226
38226 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 38226
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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38226 isn’t priced in this setting.
38226 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 38225CAR-T cell collectionBlood-derived T lymphocytes
- Use 38225 for collecting blood-derived T lymphocytes for CAR T-cell therapy; 38226 describes preparing T cells for transduction.
- 38227CAR-T preparationBefore administration
- 38227 identifies receipt and preparation of cells for administration. It is not the preparation-for-transduction step identified by 38226.
- 38228CAR T-cell administrationAutologous cells
- 38228 identifies administration of autologous CAR T cells; 38226 identifies preparation of T lymphocytes for transduction.
- 38210T-cell depletionHarvest processing
- 38210 describes T-cell depletion of a harvested cell product. 38226 concerns T-lymphocyte preparation for transduction in CAR T-cell therapy.
38226 billing questions
How is 38226 different from 38225?
38225 identifies collection of blood-derived T lymphocytes for CAR T-cell therapy. 38226 identifies preparation of T lymphocytes for transduction.
How is 38226 different from 38227?
38227 identifies receipt and preparation of cells for administration. 38226 identifies preparation for transduction.
Does 38226 identify administration of CAR T cells?
No. 38226 identifies preparation for transduction; 38228 identifies administration of autologous CAR T cells.
Does Medicare pay 38226 separately?
No. Medicare assigns status B, meaning payment for this service is included in payment for other services.
What should documentation distinguish?
Document preparation of T lymphocytes for transduction, distinguishing it from collection, receipt and preparation for administration, and administration.
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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