CPT code 38242: Lymphocyte infusion, allogeneic donor cells2026 Medicare rate & RVUs in Missouri
Reports infusion of donor lymphocytes into a transplant recipient, commonly after allogeneic stem cell transplantation to support a graft-versus-tumor response.
CMS doesn’t publish an office rate for 38242 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 38242 covers
This service covers infusing lymphocytes from an allogeneic donor into a recipient, commonly as donor lymphocyte infusion after an allogeneic hematopoietic cell transplant. A transplant hematologist or other physician managing cellular therapy typically directs the service in a hospital or transplant center. The clinical goal may include strengthening a graft-versus-tumor response, such as when disease persists or returns after transplant.
Choose this code for the lymphocyte infusion itself, not for a full hematopoietic cell transplant or a progenitor-cell boost. Documentation should identify the recipient, donor source, infused cell product, date, and clinical indication. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. 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 38242 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 | $103.80 |
| Metropolitan St. Louis, MO | Unavailable | $104.34 |
| Rest of Missouri | Unavailable | $101.29 |
How the 38242 rate is calculated
Each of 38242’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 · 38242
RVUs × geographic indexes × conversion factor
Work2.06
2.06 RVUs× 1.000 GPCI
Practice expense0.97
0.97 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
3.1700
Conversion factor
$33.4009
Medicare rate
$105.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 38242
The CMS indicators that decide how 38242 is paid alongside other services.
CMS payment indicators · 38242
Lymphocyte infusion, allogeneic donor cells
| 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
38242 without 51 · national facility
$105.88
Lymphocyte infusion, allogeneic donor cells
38242-51 · Second procedure: 50%
$52.94
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%).
38242 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 38240Cell transplantAllogeneic, per donor
- 38240 describes an allogeneic hematopoietic cell transplant. Use 38242 for a donor lymphocyte infusion, such as one given after an earlier transplant.
- 38241Cell transplantAutologous cells
- 38241 is for an autologous hematopoietic cell transplant using the patient's own cells; 38242 is for lymphocytes from an allogeneic donor.
- 38243Cell boostAfter transplant
- 38243 describes a hematopoietic progenitor cell boost. Select 38242 when the infused product and service are donor lymphocytes.
38242 billing questions
When is this code appropriate instead of an allogeneic transplant code?
Use it for an infusion of donor lymphocytes, such as a donor lymphocyte infusion after a prior allogeneic transplant. A full allogeneic hematopoietic cell transplant is reported with 38240.
How does this differ from a hematopoietic cell boost?
This code describes donor lymphocyte infusion. Code 38243 is for a hematopoietic progenitor cell boost, a different cellular therapy service.
Is same-day preoperative or postoperative care separately included?
No. CMS assigns a 0-day global period, and same-day preoperative and postoperative care is included.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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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