CPT code 38240: Cell transplant, allogeneic, per donor2026 Medicare rate & RVUs in Massachusetts
Report an allogeneic hematopoietic cell transplant when donor-derived progenitor cells are infused into a recipient to restore blood-forming function.
CMS doesn’t publish an office rate for 38240 in Massachusetts.
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 38240 covers
Allogeneic hematopoietic cell transplantation transfers donor-derived blood-forming progenitor cells to a recipient, commonly following conditioning for hematologic malignancy or marrow failure. The graft may be obtained from bone marrow, peripheral blood, or cord blood. A transplant physician manages the recipient’s transplant; infusion is generally performed in a hospital setting.
Report 38240 for transplantation of allogeneic hematopoietic progenitor cells, per donor, rather than for an autologous transplant or a donor lymphocyte infusion. Documentation should establish that donor-derived progenitor cells were transplanted and identify the donor source and recipient service; collection alone is not this service. Medicare payment is restricted to specified circumstances, so apply the applicable coverage criteria. If multiple procedures subject to the standard multiple-procedure reduction occur in the same session, the highest-valued procedure is paid in full and each other procedure is paid at 50%.
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 38240 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $218.41 |
| Rest of Massachusetts | Unavailable | $205.48 |
How the 38240 rate is calculated
Each of 38240’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 · 38240
RVUs × geographic indexes × conversion factor
Work3.90
3.90 RVUs× 1.000 GPCI
Practice expense1.89
1.89 RVUs× 1.000 GPCI
Malpractice0.25
0.25 RVUs× 1.000 GPCI
Adjusted RVUs
6.0400
Conversion factor
$33.4009
Medicare rate
$201.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38240
The CMS indicators that decide how 38240 is paid alongside other services.
CMS payment indicators · 38240
Cell transplant, allogeneic, per donor
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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
38240 without 51 · national facility
$201.74
Cell transplant, allogeneic, per donor
38240-51 · Second procedure: 50%
$100.87
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%).
38240 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 38241Cell transplantAutologous cells
- 38240 is for donor-derived hematopoietic cells; 38241 is for a transplant using the recipient’s own cells.
- 38242Lymphocyte infusionAllogeneic donor cells
- 38242 describes an allogeneic lymphocyte infusion, not transplantation of hematopoietic progenitor cells.
- 38243Cell boostAfter transplant
- 38243 identifies a hematopoietic cell boost, a distinct service; 38240 identifies allogeneic transplantation.
- 38205Stem cell collectionAllogeneic, blood-derived
- 38205 covers collection of allogeneic stem cells from a donor; 38240 covers transplantation of donor-derived cells into the recipient.
38240 billing questions
How does this differ from 38241?
Use 38240 for donor-derived cells and 38241 for a transplant using the recipient’s own cells. The distinction is the source of the transplanted cells.
Is the code reported per donor or per infusion bag?
It is reported per donor. Do not increase units just because the donor product is divided among bags or administered in portions.
Does this code cover donor cell collection?
It represents the recipient’s allogeneic transplant service, not the donor’s collection. Donor collection services are distinct and require their own documentation and coding.
What documentation supports reporting 38240?
Document that donor-derived hematopoietic progenitor cells were transplanted, identify the donor source, and record the recipient’s transplant service. The record should distinguish the transplant from a lymphocyte infusion or cell boost.
How does the multiple procedure reduction affect payment?
When this and other procedures subject to the standard reduction are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Is Medicare payment available for every allogeneic transplant?
No. CMS lists restricted coverage, meaning payment is limited to specific circumstances. The applicable coverage criteria determine whether the service qualifies.
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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